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COPYRIGHT DEPOSIT. 



THE HEALTH-CARE OF THE BABY 




CORRECT METHOD OF HOLDING AND FEEDING A BABY 



THE 

Health-Care of the Baby 

A HANDBOOK 

FOR 

MOTHERS AND NURSES 

BY 

LOUIS FISCHER, M. D. 

M 

Author of "The Health-care of the Growing Child"; "Infant Feeding in Health 

and Disease"; "A Text-book on Diseases of Infancy and Childhood"; 

Attending Physician in charge of the Babies' Wards of Sydenham 

Hospital, and to the Willard Parker and Riverside Hospitals; 

Former Instructor in Diseases of Children at the New 

York Post Graduate Medical School and Hospital; 

etc.; etc. 



SEVENTH REVISED EDITION 



FUNK AND WAGNALLS COMPANY 
NEW YORK AND LONDON 

I9l6 



o v 



* 



£W 



Copyright, 1906, 1910, 1912, 1913, 1915 and 1916, by 
FUNK & WAGNALLS COMPANY 
(Printed in the United States of America) 



Published, May, 1906 

Second Revised Edition, July, 1910 

Third Revised Edition, January, 1912 

Fourth Revised Edition, January, 19 13 

Fifth Revised Edition, December, 19 13 

Sixth Revised Edition, March, 1915 
Seventh Revised Edition, January, 1916 




JI.A420641 

( 



s 



or" 



MY WIFE 

THIS BOOK IS 

MOST AFFECTIONATELY 

DEDICATED 



PREFACE TO SEVENTH EDITION 



T^HE general character of this new book 
, * has not been changed. The chapter 
on vaccination and dentition has been en- 
larged and a new chapter added. 

The value of skimmed milk (milk without 
cream) is important for every mother and 
nurse to know. 

The technique of abdominal massage is 
illustrated. 

A new set of illustrations dealing with the 
correct method of holding a baby while 
bottle-feeding, correct way of holding a baby 
for the examination of its throat, and the 
correct method of giving an injection for the 
bowels, is added. 

I am gratified to know that this is to be 

the second revision during the year nineteen 

hundred and fifteen. 

Louis Fischer. 

155 West 85th Street, New York. 
December, 19 15. 
vii 



PREFACE TO SIXTH EDITION 



TN the revision of this little volume special 
* effort has been made to instruct the 
mother and nurse in the prevention of disease. 
With this object in view chapters on the spread 
of disease, isolation, tuberculosis, and the 
prevention of blindness have been rewritten. 

The articles on poisoning, cat and dog bite, 
and night terrors have been rewritten especial- 
ly for those who are unable to have a physician 
within a moment's call. 

Special warning has been given concerning 
the after effects of sore eyes, thumb-sucking 
and masturbation. 

The gratifying success of the previous edi- 
tions has made the author desirous of bringing 
this edition up to the demands of the times. 

155 West 85th Street, New York. 
February, 1915. 

viii 



PREFACE TO FIRST EDITION 



'TTHERE are many details pertaining to 
** ventilation, clothing, and bathing which 
every mother and nurse should know and 
which she should have in a condensed man- 
ual. The physician cannot always be at hand 
to answer the many details which the modern 
mother requires, most especially if she is out 
of town or if she is traveling. Suggestions 
and advice for infant feeding in health, and 
when the stomach and bowels are out of order, 
form the most important part of this little 
work. Directions for the management of 
fever, and a guide during such diseases as 
measles, croup, skin diseases, etc., are given. 
In cases of accidents, poisoning, etc., I have 
given ample advice to be followed until medi- 
cal help can be procured. The correction of 
bad habits, and the management of rashes 
ix 



X PREFACE 

have received careful consideration. Let me 
hope that the book will serve as a companion 
to the young mother and nurse for whose 
instruction it is intended. I desire to ac- 
knowledge my indebtedness to Alice Haehn- 
len, R.N., for many valuable suggestions. 

New York, February, 1906. 



CONTENTS 



PART I 
GENERAL HYGIENE OF THE INFANT 



The Nursery ..... 

The bed — ventilation — temperature — nursemaid, 
and toys. 



II 


Bathing and Care of the Navel 


9 


III 

IV 

V 
VI 


Clothing ...... 

By day and by night — Out-of-doors. 

Development and Growth 

Growth — weight — exercise — out-door life, and 
the carriage. 

Proper Training . . -. . 

Bowel movements — the cry, and sleep. 

Vaccination 


18 

26 

35 

42 


VII 


Dentition (Teething) .... 


44 




PART II 






INFANT FEEDING 




I 


General Feeding .... 


49 


II 


Breast Feeding .... 


52 


III 


Weaning ...... 


56 


IV 


Mixed Feeding .... 


59 


V 


Artificial Feeding .... 


6o 



XII CONTENTS 

CHAPTER PAGE 

VI Bottle Feeding 62 

Utensils required — care of the bottles — care of the 
nipples — how to heat milk for infant feeding. 

VII Home Preparation of Infant Food . 64 

Top-milk feeding — top-milk formulas for various 
ages. 

VIII Feeding a Dyspeptic Baby . . .69 

IX Skimmed Milk Feeding. Peptonized 

Milk Feeding for a Baby with Weak 
Digestion . . . . .71 

X Proprietary Infant Foods . . .74 
XI Feeding During Diarrheal Period . 77 

XII Dietary for a Child from 1 to 3 Years 

of Age 79 

XIII Food Recipes 81 

Barley water — rice water — oatmeal water — gruels 
— albumin water — nutritious lemonade — nutri- 
tious orangeade — junket — whey — beef juice- 
broths — weak tea — gelatin pudding — custard — 
soft-boiled egg — toast — raw scraped steak- 
baked Jlour — buttermilk — malt soup.j 

PART III 

MISCELLANEOUS DISEASES AND 

EMERGENCIES 
I Vomiting, Colic and Convulsions . 89 
II Constipation 93 

III Malnutrition (Marasmus), Rickets, 

Scurvy and Jaundice . . .97 

IV Fever and Temperature . . .102 
V General Rules for Contagious Dis- 
eases and Fevers — Isolation . .105 

VI Measles, Scarlet Fever, Diphtheria, 

Croup and Tuberculosis . . . 107 
VII Whooping-Cough 113 

Cold in the head — tonsillitis — adenoids — mumps- 
swollen glands — deafness — rheumatism — sprue. 



CONTENTS XI11 

CHAPTER PAGE 

VIII Skin Disease . . . . .120 

Eczema — prickly heat — chafing — chapped 
hands and face — sunburn — hives — boils — 
mosquito bites — ringworm. 

IX Accidents and Emergencies . .125 

Burns — splinters — bumps and bruises — cuts — 
foreign bodies in the throat, stomach, eye, 
nose, and ear — poisoning — bleeding — bites. 

X Ear and Eye ..... 130 

Earache — running ears — projecting ears — 
crusted eyelids — ''sore eyes." 

XI Bad Habits, etc. ... . 133 

Thumb - sucking — nail biting — bed wetting — 
masturbation — tight foreskin — circumcision. 

XII Worms — Night Terrors . . .138 
XIII External Applications and the 

Medicine Chest .... 140 
Index 145 



PART 1 

General Hygiene of the Infant 



CHAPTER I 
THE NURSERY 

IF possible the nursery should be a large 
room having plenty of fresh air and sun- 
light. Everything in the nursery should be 
washable; the walls, if possible, should be 
painted instead of papered; the furniture 
should have no upholstering; the floor should 
be of hardwood, or closely boarded and 
covered with a few rugs that may be cleaned 
with a damp cloth. 

A feather duster should never be allowed Dusting, 
in the room. Nothing should be allowed in 
the room that can not be dusted with a damp 
cloth. The screens should be covered with 
material that may be easily washed. 

The windows should have no other hang- The 
ings than oil shades, of which there should be 
a green one and a white one at each window 
to regulate the light, which should be neither 
dull nor glaring. At night, to insure proper 
repose there should be no light. With the 
modern convenience of electricity, a small 
3 



4 THE HEALTH-CARE OF THE BABY 

green glass bulb can be used when a light is 
necessary. A wax candle will answer for all 
purposes at night if electric light can not be 
used. 
The Bed. a brass or iron bed without any hangings 
should be selected. The bed should be one 
having a good woven wire mattress; it is no 
matter if the knobs and scrolls are not fancy. 
On top of this wire mattress place a heavy 
blanket folded so as to fit the bed, or a hair 
mattress. (I prefer a blanket, as this can be 
unfolded and aired daily, and occasionally 
washed.) 

Cover the mattress first with a rubber sheet, 
second a cotton sheet, third a quilted pad. 
On this pad the baby is laid and covered 
first with a cotton sheet, second with light- 
weight wool blankets and as many as are 
required for the temperature of the room. 
Down comforters may take the place of 
blankets, as they are much lighter in weight. 

The pillow should be filled with hair, never 
with feathers or down, and should never be 
more than one inch high. 

The blankets or comforters should be hung 
on the line for a good airing every few days. 
The bed should not be made as soon as the 
baby is taken up in the morning, but the bed- 



\ 



THE NURSERY 5 

clothes should be spread apart daily until 
thoroughly aired. Sheets or pads that have 
once been wet must be changed for fresh ones. 
Never put the baby in a cold bed, but see that 
the sheets are warmed by means of hot- water 
bags before the baby is placed there. 

Fresh air is of almost as much importance Fresh 
to the baby as food. That the giving of fresh 
air to the baby is sadly neglected for fear of 
"taking cold," can be seen in everyday life 
among the majority of people with whom we 
are brought in contact. A baby confined to 
a room with hot air is far more liable to catch 
cold when taken out of doors than one ac- 
customed to be in a room having fresh, cool 
air. The nursery should be thoroughly ven- 
tilated at least twice a day. This can easily 
be done while the baby is taken out into the 
street or into another room. Fresh air should 
be admitted to the nursery from windows 
communicating with the street or yard. Air- 
shaft ventilation must never be permitted. 
If the nursery has an open fireplace fresh air 
can be admitted constantly. A windowboard 
or window box may be used to admit air. 
This windowboard is a strip of wood five 
inches high and the width of the window. 
The lower sash is raised and the board in- 



6 THE HEALTH-CARE OF THE BABY 

serted. This makes a space between the two 
window sashes through which the air can 
gradually enter the room. 



ttntinm 




DAYBROOK VENTILATOR WINDOW BOX. 

These ventilators can be bought at department stores. A fine 
bronze wire screen built into the ventilator prevents dust, snow, and 
insects from entering. Sliding extensions make it adjustable to any 
window. 

Ventilator Adjusted, inside view. Air is admitted from the out- 
side, and reflected at right angles, entering the room through the 
top of the ventilator, where movable slides control the amount of 
air admitted. 



Night 
Air. 



Night air is fresh air and should be ad- 
mitted to the nursery. Children deprived of 
fresh air at night are more sensitive and hence 
contract cold in the head and "sniffles" more 
readily when taken out of doors. At night 
the nursery can be ventilated by having a 
window open in an adjoining room, or if the 
weather is not too cold, the window furthest 
from the baby's bed may be left open, and the 
screen properly placed to avoid any possible 
draught. Give the baby plenty of breathing 
room by placing the screen away from the 



THE NURSERY 7 

bed, not against the bed, as frequently seen. 

Most of our city houses and apartments Se ating 
are heated by means of a hot-air furnace or Nursery * 
with steam heat. The best method of heat- 
ing is by means of an open fire. Gas stoves 
should never be used in the nursery. If ad- 
ditional heat is necessary during the bath, an 
oil stove should be used. 

During the day the temperature of the|^ pera- 
nursery should be between 65° and 70 F., ture * 
never more. During the night it should never 
be over 65 F., and gradually reduced so that 
when the baby is about one year old it will 
not be over 6o° F. 

The selection of a nurse-maid is not an easy ^ se _ 
matter. That it is an important matter we maid * 
can see when we consider cases of tuberculo- 
sis and syphilis that have been unquestionably 
transmitted by the nurse to the child. Do not 
select a nurse-maid who suffers with catarrh 
or throat trouble. If possible select a nurse- 
maid who has been trained in a hospital de- 
voted to the care of infants. She should be a 
woman between twenty and forty years of age, 
one that is quiet, mild-mannered, and that does 
not "know everything." Experimental feed- 
ing, as frequently tried by the nurse, is re- 
sponsible for more rickets and weak children 



8 THE HEALTH-CARE OF THE BABY 

than any other method of rearing children. 
The nurse-maid should wear a dress or uniform 
that may frequently be washed. She must 
take orders from the physician and mother. 
It is the mother's place to instruct the nurse- 
maid. A mother who is dependent on a 
nurse will find that fact to be a detriment to 
her child. The nurse-maid should be in- 
structed to wash her hands in soap and water 
before preparing the baby's food. She should 
also be instructed regarding the danger of 
handling soiled napkins if she also feeds the 
baby. It is absolutely essential that she scrub 
her hands in soap and water, and brush her 
finger-nails before touching the feeding bottles, 
and handling the nipples. The neglect to do 
this may be the means of carrying particles 
from the napkin to the nipple and thus contam- 
inating the food, or giving baby a sore mouth. 
Toys. In selecting toys for the baby those made 

of ivory or rubber are to be preferred. Select 
the best quality of pure rubber and avoid 
those whose colors rub off. Avoid all "woolly 
lambs" and "woolly dogs/' as the baby is sure 
to get some of the fluff into his mouth, which 
will cause gastric disturbance. Wooden blocks 
that can be washed, not those covered with 
paper, should be given to the baby. 



CHAPTER II 
BATHING AND CARE OF THE NAVEL 

BATHING 

THE first bath given to the baby should ^ h First 
be an oil or vaselin bath. Soon after 
the baby is born the body should be anointed 
with warm olive oil or warmed vaselin. This 
oil can be applied with a large cotton wad. 
By this means we can remove the cheesy 
covering, called vernix caseosa, with which 
the baby is born. The oil bath serves the 
double purpose of cleansing the skin and 
lubricating the body so that the chilling of the 
body is prevented. An oil bath should be 
given daily until the navel cord has dried and 
fallen off. This usually happens between the 
fourth and eighth days. The first tub bath 
may now be given. Requisites for the Tub 
Bath are: A warm room, temperature 70- 
7 2 F.; papier-mache bath-tub on a low table; 
a basin of fresh warm water; two soft sponges 
or wash cloths; two large soft towels; a bath 
thermometer with wooden case ; olive oil soap 
9 



IO THE HEALTH-CARE OF THE BABY 

or Unna's superfatted soap; a powder shaker 
containing pure talcum powder; several 
toothpicks on which a little absorbent cotton 
is tw T isted; a soft brush and fine comb; a 
large flannel bathing apron. 
The When giving the baby a bath, see that the 

ture of temperature of the room is between 70-7 2° F. 

Bath and , , ' , 

Room. Place the tub where there is no possibility of 
a draught, or avoid draughts by means of 
screens. Never place the tub on the floor, 
but always on a low stand or table. For a 
very young infant have the temperature of the 
bath between 98-100 F. As the baby grows 
older, gradually lower the temperature so that 
when baby is one year old the temperature is 
between 85-90 F. Always use a bath ther- 
mometer, never guess at the temperature, as 
the water will feel very much warmer to the 
sensitive skin of the baby than to a hand ac- 
Howto customed to hot water. After everything is 
Bath. prepared for the bath, and the fresh clothing 
for the baby is warmed, tie on the large flan- 
nel bathing apron. Undress the baby and 
take him on your lap. Cover all but his head 
with the flannel apron. After bathing the 
face with the fresh water from the basin, soap 
the cloth and carefully wash the head and 
scalp. Dry the face and head thoroughly. 



BATHING AND CARE OF THE NAVEL II 

The entire body is now carefully bathed with 
soap and warm water from the basin. Keep 
the baby wrapped in the flannel apron as 
much as possible while this is being done. 
Now lift him gently into the fresh warm water 
in the bath-tub. Use a fresh cloth and thor- 
oughly rinse off all soap. After remaining in 
the tub for two or three minutes he should be 
lifted out of the tub and placed on the warm 
towels which have been prepared on the bed. 
Wrap the towel around him and gently pat 
him dry. Use the second towel to dry all the 
little folds of flesh, under the arms, at the 
neck, between the thighs, etc. Lift the baby 
from the damp towel on to a dry blanket, rub 
him with alcohol, and dust a little talcum 
powder on the neck, behind the ears, under 
the arms and knees, in the groin and on the 
buttocks. Wipe away the superfluous powder 
as it will only irritate the skin, especially in 
the groin where it is likely to get wet and cake. 
As baby grows older he may remain in his 
bath longer — from five to ten minutes, espe- 
cially during the summer. After the morning 
bath he should receive a dash of cold water 
over his spine. This had better be given by 
means of a large sponge saturated in cold 
water. While the baby is still seated or 



12 THE HEALTH-CARE OF THE BABY 

standing in the bath water, this saturated 
sponge should be held back of his head, the 
water squeezed out and allowed to run down 
his back. By the use of cold we contract the 
blood-vessels and prevent chilling of the sur- 
face. This plan is most admirably adapted 
for hardening the baby, thus preventing him 
from taking cold easily. 
The m If the baby is a boy the foreskin should be 

pushed back every day and the parts carefully 
washed with cotton and warm water, remov- 
ing all white particles collected there. At 
times the use of borated vaseline is necessary. 
When it is impossible to push the foreskin 
backwards and clean the parts, then pieces of 
smegma may cause the trouble and it will be 
necessary for the physician to force the foreskin 
backwards to remove the smegma. When this 
is impossible circumcision will be necessary. 
rhe scalp The scalp need only be washed two or 
bmst). three times a week, unless it is covered with 
greasy scales (milk crust) as is quite common; 
then it should be washed every day and 
anointed with melted cocoa butter. If these 
greasy scales persist, the physician should be 
consulted. Be very careful when washing the 
scalp or removing these scales, as the fontanel 
or "soft spot" on the top of the head is open. 



BATHING AND CARE OF THE NAVEL 13 

Do not rub over this spot roughly or allow 
anything to fall on it or strike it. 

After baby is dressed his nose and ears To clean 
should be cleaned by means of wooden and Ears. 
toothpicks on which a little absorbent cotton 
is twisted, care being taken to see that the 
end is well covered. Dip the covered end of 
one of these toothpicks into a solution of boric 
acid and insert into the nose; by gently mov- 
ing it around the nostril remove as much of 
the secretion as possible. Clean the ears in 
the same manner, but use a freshly mounted 
toothpick for each ear and nostril. 

Boric acid solution for the baby's toilet is 
made by adding a teaspoonful of boric acid 
powder to a pint of boiling water, or can be 
bought from the druggist by asking for a two 
per cent, solution of boric acid. 

Baby should receive daily washings of hiscareof 
mouth by giving him a drink of water after 
each feeding. The old method of cleansing 
the mouth with a solution of boric acid on 
cotton or gauze frequently causes ulceration. 
The lining of the mouth is so delicate that the 
slightest friction may cause inflammation. 

When the teeth are present they should be Care of 

r . , the Teeth. 

kept clean. Neglect of the teeth will result in 
caries and foul breath; particles of milk some- 



14 THE HEALTH-CARE OF THE BABY 

times remain between the teeth, turn acid, 
and so destroy the enamel of the teeth. Baby's 
teeth are best cleaned by means of a small 
piece of cotton dipped in a weak solution of 
bicarbonate of soda and water. The teeth of 
older children may be cleaned with a brush 
and a teacup of warm water to which half a 
teaspoonful of table salt has been added. 

The Eyes. To cleanse the eye dip a small pledget of 
cotton into a two per cent, boric acid solution. 
Hold this cotton near the eye and squeeze the 
cotton, letting a little of the solution fall on 
the eyelid. Let it remain for a few moments; 
do not attempt to open the eye as the solution 
will trickle there itself; wipe, but do not rub, 
the eye gently toward the nose with a dry 
piece of cotton, using a fresh piece of cotton 
for each eye. 

The Nails If it is necessary to shorten the nails they 
should be cut, not bitten off, before the baby 
is bathed. After the bath any remaining 
foreign matter under the nails may be re- 
moved with a wet toothpick. 

The hair should be brushed with a soft 
camel's hair brush. 

when to It is well to give the bath just before putting 

Bathe the ■ - . . to _ , , r i . r * 

s*by the baby to bed and before the evemng feed- 
ing. It makes him sleep better and there 



BATHING AND CARE OF THE NAVEL 1 5 

is no danger of his catching cold by being 
carried about. Never give a bath directly 
after a meal or just before the baby is to be 
taken out. In the morning one hour after 
his feeding he may have a sponge bath. Dur- 
ing the summer months the baby may have a 
tub bath (one minute dip) in the morning in why Baby 
addition to his evening tub bath. There are Have a 

Bath 

four channels by which impurities can be re- D«iy. 
moved from the body; they are: 1. The skin; 2. 
The kidneys; 3. The intestines; 4. The lungs. 

To remove impurities through the skin, the 
pores must be kept open. This can only be 
attained by bathing. Besides cleansing the 
skin the bath exerts a very soothing influence 
on the nerves. Very nervous children will 
appear more calm after a bath, so that children 
who are restless at night will be strengthened 
and soothed by this simple means. 

If the baby's skin shows a tendency to be sensitive 
red and chafed then it is advisable to use no 
soap at all, but an ordinary bath or an oat- 
meal bath made in the following manner will 
be found advantageous: 

Tie one pound of oatmeal into a bag made oatmeal 
of cheesecloth. Place this bag in the baby's 
bath-tub; let it soak in hot water for about 
one half hour, and then add enough water to 



10 THE HEALTH-CARE OF THE BABY 

bathe the baby. The duration of the bath 
should be from five to ten minutes; the tem- 
perature of bath 95 F. 
When to Do not bathe the baby if he has an eczema 
Bathing, or a very reddened skin. (Read also the 
article on Eczema on a later page.) Do not 
bathe him if an eruption is present, unless the 
eruption is due to an irritation applied to the 
skin. Turpentine, mustard, and camphorated 
oil, when rubbed into the skin, will cause an 
eruption resembling scarlet fever. Under 
such conditions the bath may be used. When 
fever develops the bath may be continued, 
provided there is no eruptive disease like 
measles or scarlet fever. When baby has a 
cough or catarrhal manifestations, it is ad- 
visable to discontinue the bath for a few days. 

CARE OF THE NAVEL 

The nurse in charge of the baby must 
thoroughly wash her hands and clean her 
nails before touching the cord. 
At Birth. Dry dressing only should be used. The 
cord should be dusted with pure talcum 
powder and wrapped in several thicknesses 
of sterilized cheesecloth or clean, soft linen. 
A clean dressing should be renewed daily 
until the cord falls off. 



BATHING AND CARE OF THE NAVEL 1 7 

Sprinkle talcum powder into the navel After the 

1 • 1 ii r i Cord Falls 

and cover it with several layers of cheese- off. 
cloth or linen, 4 over which apply the belly- 
band. 
If proper cleanliness has not been observed, sore 

. . Navel. 

inflammation of the navel will result. If such 
is the case, the skin surrounding the navel will 
appear reddened and an oozing or discharge 
of pus follows. The physician's attention 
must be directed to this condition, the neglect 
of which may result in blood-poisoning. 

When baby strains very hard to have a Rupture 
movement of the bowels a rupture of the navel Navel, 
sometimes follows. This protruding mass 
feels soft, and a distinct gurgling sound can 
be heard when it is replaced or pushed back 
by the finger. Straining during constipation 
or straining during continued diarrhea may 
cause this condition. Violent coughing spells 
such as occur in whooping-cough may also 
cause this rupture. A snug-fitting abdominal 
binder evenly placed will support the abdo- 
men and hold this rupture in place. It is 
best to consult the physician the moment the 
rupture is noticed. Until then a strip of zinc 
oxide adhesive plaster i% inches in width 
should be tightly drawn around the body 
covering the rupture. 



CHAPTER III 
CLOTHING 

THE new-born baby requires the follow- 
ing clothing: During the day, a flannel 
band; a diaper; socks; a long-sleeved shirt; 
a flannel pinning blanket; a white dress. At 
night, a flannel band; a long-sleeved shirt; 
a diaper; a flannel night-dress. 
The The flannel band should be long enough 

Band. to reach twice around the baby's body and 
should never be more than four inches in 
width. It will interfere with the breathing 
if brought up too high. It should have no 
seams or hems to cause uneven pressure, as 
it must fit snug, but not too tight. This band 
should always be closed on the left side; 
whenever possible it should be closed by 
basting with needle and thread. If the baby 
is restless and this can not always be done, 
then it may be fastened by using four of the 
smallest size safety pins. 
The Knit This flannel band should usually be dis- 

Band. J 

carded after the baby reaches the age of three 
18 



CLOTHING 19 

months. When this band is discarded, a lisle 
or knit silk and wool band should be used in its 
place. This band is held in position by means 
of shoulder straps and diaper tag. 

The diaper should be made of soft bird's- The 

Diaper. 

eye cotton or linen. For a very young baby 
it should be made about eighteen inches 
square and folded but once. Knitted or 
stockinette diapers are light, porous and elas- 
tic and yield to all strains and motions of the 
body; they can be bought in the stores. I 
especially recommend them for children after 
they are placed in the sitting position. 

Never place a small folded diaper inside 
of the regular diaper; this would cause too 
much thickness between the baby's legs, and 
may cause the legs to assume a bowed appear- 
ance, especially if the bones are soft and bend 
easily. The baby should never have more 
than two thicknesses of cloth between his 
legs. To protect the skirts from the excess 
of urine, a quilted diaper pad about twelve Quilted 

Diaoei* 

inches square can be laid directly under the Pad. 
baby after he is diapered, and the skirts then 
arranged over this pad. This pad should 
never be tied by means of strings around the 
baby's waist as is so often seen, as this brings 
the weight on the hips. By careful handling 



20 THE HEALTH-CARE OF THE BABY 

the pad will remain in position when the baby 
is taken in arms. Never resort to a rubber 
diaper, for sanitary reasons. 

The diaper once wet must never be dried 
and used again, for unless the baby is per- 
fectly normal the urine may contain sub- 
stances which will irritate the buttocks and 
thighs, thus causing redness and chafing. At 
times eczema will result from constant irrita- 
tion. When there is redness and irritation of the 
buttocks, or genitals, do not use soda or strong 
soap in washing the diapers, use only olive 
oil or castile soap, and no bluing, dry in the 
open air and sun, never in or near the nursery. 
The Over the band a lisle or light-weight silk 

and wool shirt with high neck and long 
sleeves is worn in summer, a second weight 
silk and wool shirt in spring and fall, and 
a third or heavier weight in winter. The 
fourth or very heavy weight shirts found in 
our stores should never be used in our climate. 
Silk and wool shirts should be used because 
they are light in weight and wash well. Woolen 
materials shrink and become hard in washing. 
A combination of silk and wool, no matter 
how often washed, remains soft, retains its 
original size and shape and gives freedom 
with every motion of the baby's body. 



CLOTHING 21 

Next comes the pinning blanket. This is The 
always made of light-weight flannel, and made Blanket. 
after the regular skirt pattern, only that it is 
left open in the back the full length of the 
skirt, thus making it more convenient in 
handling the baby, changing the diaper, etc. 
This pinning blanket may also be modeled 
after the popular " Gertrude" pattern. After 
the pinning blanket is closed, the skirt part is 
folded, and turned up at the bottom and 
pinned with several safety pins, so as to reach 
just above the hem of the dress. This will 
keep the cool air from the baby's feet and at 
the same time give him plenty of room to 
kick or move his limbs. 

When baby is put into short clothes, about The 
the age of five months, a short flannel skirt, skirt. 
on a flannel body in winter, on a cotton body 
in summer, takes the place of the pinning 
blanket. Over the flannel petticoat mothers 
usually insist on putting a white petticoat 
because it "looks better." This is not neces- 
sary and only adds more weight to the baby's 
clothes. 

The dress, skirts, and band are slipped over The 
the infant's feet, never over its head. On 
cold days the baby should wear a dress of 
flannel or a flannel or cashmere sack over the 



22 THE HEALTH-CARE OF THE BABY 

white dress. The baby's clothes should be 
made plain, avoiding all ruffles, plaiting, and 
useless trimmings ; allow only enough ful- 
ness for comfort; select fine, soft materials, 
and when trimming is considered indispensa- 
ble, use laces instead of embroideries. 
Blankets It is advisable to have several light woolen 
Wrappers, wrappers which can be quickly slipped on 
the baby whenever necessary. Knitted wool 
blankets are more serviceable than the bought 
woolen blankets for wrapping baby, as they 
are light in weight and can be more easily 
washed, more quickly dried and remain softer 
than the woven blankets. 
The Socks The feet should be covered with very 

and Shoes. J 

closely knitted silk and wool socks. When 
the clothes are shortened soft moccasins or 
kid shoes and merino or silk and wool stock- 
ings take the place of the woolen socks or 
booties. 

When the baby is able to stand on his feet 

and shows signs of taking the first steps, a 

shoe with a flat, broad sole should be made to 

fit the individual child's foot as accurately as 

The possible. An inside ankle support should be 

Ankle *. ■ . , """", . ,. -i i 

Support, fitted into the shoe. Another shoe that an- 
swers the same purpose is made with whale- 
bones fitted at the sides. Laced shoes are 



CLOTHING 23 

preferred to buttoned ones as they can be made 
to fit the foot better. 

The baby's clothes should be shortened when to 

iii» i»i 1 • r Shorten 

when he begins to kick or show signs of Baby's 

& b Clothes. 

wanting to use his limbs — this is about the 
fifth month. It is not wise to make this 
change during cold weather. If the baby is 
born in July it is better to shorten the clothes 
in October, the beginning of the fourth month, 
rather than wait until November and make 
the change during very cold weather. 

The baby should always be dressed while Position 
lying on his back on a soft bed or a pillow, while 
Very little or no turning of the baby is neces- Dressed, 
sary. The band, as said before, may be 
slipped over the feet, the body gently raised 
by grasping the feet, the arms slipped through 
the shoulder straps and the band then slips 
into place without turning the baby. The 
skirts and dress are laid together and slipped 
over the legs at the same time; after the sleeves 
are gently worked over the arms the baby is 
turned on the right side and the skirts and 
dress are closed. If a sack is required the left 
arm can be slipped into the sleeve while the 
baby is still on the right side; one more turn- 
ing of the baby to the left side will permit the 
right arm to be slipped into the right sleeve. 



24 



THE HEALTH-CARE OF THE BABY 



When 
Com- 
fortably 
Dressed. 



When too 

Warmly 

Dressed. 



Night 
Clothing. 



Street 
Clothing. 



When the baby has on the right amount of 
clothing his limbs will be pink or the skin 
mottled. They should not be bluish, as they 
usually are when the baby is not dressed warm 
enough. In special cases, where, for example, 
heart disease exists, continued blueness of the 
limbs is found. Such cases require careful 
medical supervision. 

When the baby is too warmly dressed per- 
spiration will result. This has a weakening 
effect, besides producing a sensitive skin, which 
means less resistance and a liability to take 
cold easily. 

A baby under twelve months is put to bed 
with a shirt, a diaper, and a flannel or flannel- 
ette nightdress, which is made long enough to 
allow the hem to be gathered on a drawing- 
string. This will insure the baby's feet being 
covered even though the outer covering be 
kicked off. 

After the baby discards the diaper at night, 
night-drawers, which will be found more serv- 
iceable and comfortable, may be worn. 
These can be made of canton flannel or can 
be bought made of stockinette. 

When the baby goes out-of-doors he needs, 
in addition to the regular house clothes, a 
long woolen or wool-lined coat with shoulder 



CLOTHING 25 

cape as an extra protection; a silk cap with 
heavy lining; woolen mittens; a lace veil 
(bobbinet), which may be worn on very windy 
days or when asleep in the carriage. A 
woolen veil should never be worn, as there is 
danger of the baby swallowing some of the 
fluff. After the baby is in short clothes leg- 
gins will be necessary in cold weather. Dur- 
ing the summer a pique coat and a thin lace 
cap are all that is necessary. 



CHAPTER IV 

DEVELOPMENT AND GROWTH 

THE average height of the new-born male 
is from 19J to 20 inches (about 50 centi- 
meters) ; of the female from 19I to 19! inches 
(about 48.5 centimeters). A child grows most 
rapidly during its first year. The increase 
during the first year is 5 to 6 J inches; second 
year, 2 J to 3 \ inches; third year, 2 \ to 2§ 
inches; fourth year, about 2 inches; fifth to 
sixteenth year annual increase from i\ to 2 
inches ; sixteenth to seventeenth year, 1 \ inches ; 
seventeenth to twentieth year, 1 inch yearly. 

Diseases of the bones, rickets, and scrofula 
retard growth. A child should begin to walk 
at the end of twelve months. If a child when 
beginning to walk uses chiefly its toes and has 
a limping gait, more especially if symptoms 
of pain be noticed in one knee, and tender- 
ness be caused by handling the limb, the phy- 
sician should be consulted. 

The growth of hair seen on the baby's head 
at birth usually falls out during the first three 
26 



DEVELOPMENT 27 

or four weeks of life, and then a new growth 
gradually takes its place. This hair is light 
in color, but usually becomes darker as the 
baby grows older. 

During the second month the baby shows 
signs of intelligence. This is the time when 
the mother and nurse think it necessary to 
entertain the baby, but this gives more pleas- 
ure to the mother than to the baby, whose 
nervous system is very delicate. The brain is 
very active during the first year of life and 
therefore requires rest and quiet. During the 
third and fourth months the baby learns to 
hold up his head if his back is supported. 
He will learn to recognize his mother and he 
begins to smile and "coo." The first tears 
are usually seen during the third month. 
During the fourth month the baby begins to 
notice his toys. The salivary glands become 
active and drooling begins. During the sixth 
month he tries to sit up unsupported. This 
should not be encouraged or allowed until 
the seventh month and then only for a few 
moments at a time. During the seventh 
month the first tooth usually appears. Dur- 
ing the ninth and tenth months the baby at- 
tempts to lift himself up on his feet, and dur- 
ing the tenth and eleventh months he is able 



28 THE HEALTH-CARE OF THE BABY 

to stand with assistance. The first attempts 
at walking are generally made during the 
twelfth month, and at fourteen or fifteen 
months the baby as a rule is able to walk very 
well alone. The baby should never be en- 
couraged to walk; he will walk of his own 
accord when his muscles and bones are strong 
enough to support him. He begins to talk 
about the twelfth month, his first words usually 
being Mamma and Papa. The fontanel or 
"soft spot" in the baby's head should be com- 
pletely closed by the end of the eighteenth 
month. 
Very The center of speech may be inactive and 

speaking, show no signs of development until the end 
of the second year. If the child is otherwise 
healthy, no alarm need be felt at this state of 
affairs. If, however, the child is backward 
in its physical development, as well as its men- 
tal development, then treatment must be 
sought to remedy this condition. 
sudden If an infant showing proper development 

speech. begins to speak, and for no apparent reason 
then stops speaking, the cause of the condi- 
tion should be carefully investigated. A child 
suffering from a severe infectious disease, like 
diphtheria, may during convalescence, de- 
velop paralysis, which might cause the sud- 



WEIGHT AND FEEDING RECORD 



AGE 


Weight 
Pounds Ounces 


Gain+ 
Loss — 
Ounces 


Food 


Stool 


1 week 










2 weeks 










3 weeks 










4 weeks 










5 weeks 










6 weeks 










7 weeks 










8 weeks 










9 weeks 










10 weeks 










11 weeks 










12 weeks 










13 weeks 









WEIGHT AND FEEDING RECORD 



AGE 


Weight 
Pounds Ounces 


Gain+ 
Loss — 
Ounces 


Food 


Stool 


40 weeks 










41 weeks 










42 weeks 










43 weeks 










44 weeks 










45 weeks 










46 weeks 










47 weeks 










48 weeks 










49 weeks 










50 weeks 










51 weeks 










52 weeks 











WEIGHT 29 

den cessation of speech. The neglect of 
treatment at such a time may result in perma- 
nent injury to the child. 

The baby should be weighed at regular when to 
intervals. Nothing else tells so accurately 
whether or no he is thriving. For the first year 
the baby should be weighed every week. Dur- 
ing the second year, every two or four weeks 
will be sufficient. The best time to weigh the 
baby is when he is undressed, just before his 
bath. 

He should be weighed in the same scales How to 

b Weigh. 

each time. The scales must be accurate. 
Scoop scales are best adapted for young in- 
fants. When weighing the baby undress him, 
and wrap him in a small blanket and place 
him in the scoop of the scales; balance the 
scales and note the amount; then remove the 
baby and after dressing him, weigh the blanket 
in which he was wrapped; deduct the weight 
of the blanket from the total and the re- 
mainder will be the weight of the baby. 

The average healthy baby weighs from Normal 
seven to seven and one-half pounds at birth. 
A few ounces are generally lost during the 
first week. These are made up during the 
second week and then the baby should gain at 
the rate of four to eight ounces each week 



30 THE HEALTH-CARE OF THE BABY 

up to the sixth month. The gain from the 
sixth to the twelfth month is less, usually from 
two to four ounces a week. 

A healthy baby properly fed does not loose 
in weight. There are times when the baby 
will gain very slightly and probably for a few 
weeks not at all, and still be in a healthy con- 
dition. During the teething period and dur- 
ing very hot weather the baby as a rule gains 
very little in weight. 

Weight in 
Age. Pounds. 

Weight at birth 7§ 

Weight at 1 month 9 

Weight at 2 months ni 

Weight at 3 months I2§ 

Weight at 4 months 13! 

Weight at 6 months 16J 

Weight at 8 months i8j 

Weight at 10 months 19I 

Weight at end of 1 year 21 

Weight at 1 year, 3 months 22 

Weight at 1 year, 6 months 22§ 

Weight at 1 year, 9 months 24 

Weight at end of 2 years 26 

Some babies fed on prepared infant foods 
or those foods containing a great deal of 
starch, will gain rapidly in weight. 

A normal baby usually doubles its weight 
at the end of the fifth month, and by the end 
of the first year weighs three times its weight at 
birth. Taking seven pounds as the average 



EXERCISE 31 

weight for an infant at birth, it should weigh 
fourteen pounds at the end of the fifth month 
and twenty-one pounds at the end of the first 
year. The table opposite shows the gain in 
weight of a healthy baby that was fed at the 
breast. 

For the first two weeks of life the baby Kicking 
takes very little physical exercise, but after Exercise. 
this he begins to kick and move his arms 
around in a manner which insures plenty of it. 
His clothing should be loose enough to permit 
him to use his arms and legs freely. He gets 
exercise while in his bath, kicking his legs and 
moving his arms. A cool sponge bath of the 
body chills the surface and causes the baby 
to draw long breaths; this expands the lungs 
and is the best form of pulmonary gym- 
nastics. When the baby cries from temper 
let him alone — his lungs are exercised by 
crying. 

When carrying the baby change him from deeping, 
one arm to the other so that he may learn to 
use and exercise both arms equally. 

When the baby is six months old place him 
on a large, clean rug and permit him to rail 
and creep at will. This exercise requires no 
regulation except precautions against dan- 
gerous places. 



32 THE HEALTH-CARE OF THE BABY 

walking. Do no t p U t the baby on his feet. When 
he can pull himself up on his feet by his 
own effort, it will be time to encourage him 
to make the effort to stand and walk. 
Later on, walking will be the best out-door 
exercise, 
gaby's if the baby is born in summer and per- 

outings. f ec tly normal, he should be given his first 
outing when eight or ten days old. If born 
in winter he must be gradually accustomed 
to out-door life. This is best done by dressing 
him in cap and coat in addition to his house 
clothes and placing him in his carriage in 
the nursery. Open the windows from the 
top, close all doors so there is no draught and 
wheel the baby back and forth for an hour 
or more. This method of giving fresh air can 
also be employed when the baby is older and 
the streets are wet or when very sharp winds 
are blowing. When the baby is two months 
old, he may be taken out in dry, cold weather. 
Begin by letting him stay out for an hour or 
two in the warmest part of the day. Grad- 
ually increase the length of time from week 
to week until the baby is accustomed to out- 
door air, when he can remain for several 
hours at a time each nice, dry day. In sum- 
mer the baby may remain out doors until 5 



THE CARRIAGE 33 

o'clock and in the winter until 3 o'clock if 
the air is clear and dry. 

In summer the baby should be taken into 
the house or in the shade during the hottest 
part of the day, from 12 noon to 3 p. m. 

Select a carriage that is strongly built, that The 

& . Carriage, 

has good springs, wheels with rubber tires, 
and a top that can be made to fit tightly about 
the head of the carriage. This top is espe- 
cially valuable in winter, as it keeps off all 
winds. Separate tops of linen can be bought 
for use during the summer. These tops, 
whenever possible, should be lined in green, 
as this color is the least trying to the baby's 
eyes. In winter the carriage should contain 
a hair pillow covering the bottom of the car- 
riage and another small, flat, hair pillow for 
the baby's head. Over the pillow should be 
placed a knit wool blanket. The baby should 
be placed on this blanket which then should 
be carefully wrapped around him. Another 
wool blanket or afghan should be placed 
over the baby and tucked well in at the sides 
and foot of the carriage. Over this a fur robe 
should be placed in very cold weather. In 
summer cotton covers take ike place of the 
wool blankets. When the baby is still very 
young it is better for the nurse to stay on 



34 THE HEALTH-CARE OF THE BABY 

one block so as to avoid jars at crossings 
or curbs. When it is necessary to take the 
carriage over curbs, the hind wheels should 
be gently let down first. This avoids that 
sudden forward jar of the baby and leaves 
him in a comfortable position. 

As the baby grows older and is able to sit 
up, or about the ninth month, the seats w r hich 
are bought with the carriage may be used 
and arranged so as to give him the proper 
position. 
Feeding The best place to feed the baby is in the 

in the r J 

carriage, house, although I frequently permit a baby 
to be fed, in the carriage, out of doors during 
the summer. 
sleeping There is no objection to the baby's sleeping 
carriage. w hen in the street. There is no more danger 
of his taking cold while asleep than when 
awake. We invariably find those children 
who sleep out of doors less prone to take cold. 
See that baby is dressed warm and placed in 
the sunshine with his face and eyes protected 
from the sun and wind, and he will sleep with 
comfort and advantage. 



CHAPTER V 
PROPER TRAINING 

FROM earliest infancy it is advisable to Resting, 
train the baby. He should be given the 
breast, and after nursing or feeding from the 
bottle, be laid in his bed. If this habit is 
begun early a regular habit of resting can be 
formed. 

When baby is three months old he can be The 
taught to use the commode. He should be 
placed on a small chamber held in the nurse's 
lap. As he grows older and strong enough 
to support his back he may be placed on his 
chair or commode. The best time to have 
baby's bowels move is in the evening before 
his bath or evening feeding. As baby grows 
older his bowels will move with less effort 
after his feeding, but this should not be en- 
couraged while he is young, as he is liable to 
regurgitate his food. If baby makes no at- 
tempt to move his bowels when placed on the 
commode, then a small soap stick, or a gluten 
or glycerin suppository, should be inserted 
35 



36 THE HEALTH-CARE OF THE BABY 

into the rectum. By this means we direct the 
baby's attention to the reason of his being 
placed on the vessel. Such treatment may 
be repeated daily for weeks or until baby's 
bowels move unaided. 
sanitary Each child should have his own vessel or 

Nursery 

seat. kj s own sea t as a sanitary measure. These 
sanitary wooden seats can be bought at any 
of the large department stores of New York 
City. They can be laid on any vessel and 
prevent the child's body from coming in con- 
tact with the vessel. As they are small in size 
they are adapted for the young infant as well 
as the older child. 

The What is possible with the bowels can be 

accomplished with the bladder. If the mother 
or nurse will place the infant on a vessel 
every three or four hours he will gradually 
learn to hold his urine until such time. He 
should be placed on the vessel immediately 
on awakening, be it night or day. Children 
invariably empty the bladder on awakening. 

Normal At birth, the baby may normally have from 

ments. three to four movements in twenty-four hours. 
As he grows older one or two movements a day 
will be sufficient. While the baby is fed on 
a milk diet his stool should be yellowish in 
color, smeary or pasty-like in consistency, and 



PROPER TRAINING 37 

the smell should be acid, but not disagreeable. 
As soon as an exclusive diet is changed to a 
mixed diet, the stools lose the yellow color 
and become darker, and resemble more those 
of an adult, though remaining softer and 
thinner throughout infancy. 

Mucus is always present in all healthy Mucus, 
stools, but is so well mixed that it does not 
appear as mucus to the naked eye. Any ap- 
pearance, therefore, of mucus easily visible 
should be regarded as abnormal. 

Abnormal stools requiring treatment are Abnormal 

1 ° ^ Move- 

these: Greenish stools resembling spinach ; ments - 
greenish stools containing small, white parti- 
cles; brownish stools having a very offensive 
odor; thin, brownish stools resembling muddy 
water, passed with considerable flatus (gas); 
dry, white or light gray stools; stools with 
jelly-like masses or long shreds of mucus; 
stools passed in hard, dry balls; stools mixed 
with blood. 

To develop an infant's brain the nervous Hygiene 
system requires quiet but cheerful surround- Nervous 
ings. Useless excitement is harmful. To 
take the baby and handle him like a toy is 
wrong. I have seen infants taken up from a 
sound sleep to display the "talent" that some 
one has taught them. Nothing is more harm- 



38 THE HEALTH CARE OF THE BABY 

ful than to have the mother compel her infant 
to display various tricks during its feeding. 
While this is a gratification to the friends, it 
certainly is detrimental to the infant's brain 
and nervous system. 

Crying. A certain amount of crying is necessary for 

the baby if he is to be healthy and strong, for 
this is the way he exercises his lungs and sends 
the blood to the extremities. 

This normal cry is loud and strong and 
baby may indulge in it frequently; even 
though he gets red in the face this cry is health- 
ful. A careful and observing mother will 
soon learn to know this cry from the cry of 
pain, hunger or discomfort. 

causes. The baby may cry because he is hungry, or 

thirsty; his napkin may be wet; he may be 
frightened or sleepy; his clothing may be un- 
comfortable; he may be tired lying in one 
position, or he may be crying from temper 
and want to be indulged. 

When the baby cries see that he is com- 
fortable, that the napkin is not wet, that the 
hands and feet are warm, that the clothes are 
smooth under him, that no pins are pricking 
him and change his position. 

Due to If he is crying from colic the cry is strong, 

sharp, and spasmodic and often accompanied 



cry 39 

by a drawing up of the legs and a contraction 
of the features. 

The cry from earache is a continuous whine Due to 
and often the hand is brought toward the 
head. 

The cry of hunger is a continuous fretful Due to 

. . Hunger. 

sound, heard soon after feeding or some time 
before the next meal is due, and is usually 
accompanied by the sucking of the thumb or 
fingers. 

When the baby is very ill or weak the cry Due to 
will be low or moaning. 

The cry of temper is loud and strong and is 
accompanied by kicking and stiffening of the 
body. It can easily be distinguished from 
other cries, for when baby gets what he wants 
he immediately stops. This cry of temper 
should never be given in to or the mother will 
regret it later on. The training can not be- 
gin too early. When the baby cries from 
fright he should be taken up and comforted 
and as soon as quieted put back on his bed 
again. 

When the baby cries and all causes but 
temper have been eliminated, then let him 
"cry it out," even if he cries an hour. The 
second struggle will not last so long. The 
third will be still shorter. If the abdominal 



40 THE HEALTH-CARE OF THE BABY 

band is properly applied no rupture can re- 
sult from this crying. 

In cases of habitual crying it is better to 
get the opinion of a physician as to the cause 
before subjecting the baby to too rigid disci- 
pline. 

sleep. A new-born baby sleeps about nine-tenths 

of the time. The sleeping time gradually 
diminishes and when the baby is five months 
old he usually sleeps all night and requires a 
long nap of two or three hours in the morning, 
and another of about one hour in the after- 
noon. The healthy baby sleeps with his 
mouth closed, the nostrils can be seen dilating 
gently and the chest moving slightly and regu- 
larly. The baby should never perspire while 
sleeping but the skin should remain warm. 

Proper The baby should be put to bed while awake. 

He should first be fed, made comfortable and 
the room should be darkened. He should 
neither be rocked nor sung to sleep; if left to 
himself will soon learn to fall asleep quietly. 
He should be put to bed no later than six 
o'clock, and should continue his afternoon 
nap until four years old or longer. 

causes of Disturbed sleep or sleeplessness is usually 

Disturbed . i«iii 

sleep. caused by improper feeding, and m the bottle- 
fed infant by over-feeding or too frequent 



PROPER TRAINING 41 

feeding. Intestinal indigestion and colic are 
the most frequent causes. Discover the cause 
and remove the disturbance yourself if pos- 
sible; failing to do so consult a physician, as 
the trouble may be due to large tonsils, ade- 
noids, spine or hip disease, chronic joint 
pains, earache or toothache. See that the 
baby's feet are warm. Do not give him too 
much clothing. Give him plenty of fresh air 
in the room. Do not excite him with a new 
toy or romping play, and do not arouse fear 
before putting him to bed. Do not use sooth- 
ing sirups or other medicines. 

When the baby is put to sleep his hands Bad 
must always be outside of the blanket or bed 
clothing. Bad habits are easily acquired, es- 
pecially so if the genital parts are unclean. 
Any itching may cause a desire to scratch, 
later on, this may lead to constant fumbling 
and if this latter is not corrected we may find 
that our baby is addicted to one of the worst 
habits found in infants or children — namely, 
masturbation. 



CHAPTER VI 
VACCINATION 

TO prevent a child from taking smallpox 
it should be vaccinated. All infants over 
two months old may be vaccinated. If small- 
pox exists in a locality or if an infant has 
been exposed, he should be vaccinated im- 
mediately. 

No mother or nurse should attempt to vac- 
cinate a baby; a physician should always be 
called. With care and cleanliness there is 
little or no danger of complication; on the 
other hand if the slightest amount of dirt 
from a finger nail or any other contamination 
is introduced into the wound, a child may 
contract erysipelas, which may lead to blood- 
poisoning and death. Five to seven days 
after vaccination, inflammation or redness 
around the vaccinated area will be noticed. 
This is the natural course "of taking." If 
this redness spreads and the skin is swollen 
and tense the physician will usually prescribe 
a cool, moist dressing of lead water or a one 
42 



VACCINATION 43 

per cent, boric acid solution. The reddened 
surface is to be covered with gauze moistened 
with one of these solutions until the inflam- 
mation subsides; this usually takes two or 
three days more, in all about ten days. 



CHAPTER VII 
DENTITION (TEETHING) 

THE infant's first set of teeth are called 
the milk teeth. The second set begin to 
appear after the sixth year and are known as 
the permanent teeth. 
Drooling. When the baby is about four months old 
the flow of saliva usually begins, or is very 
much increased, so that a bib must be pro- 
vided. This "slobbering," as it is famili- 
arly called, is not a sign that the teeth are 
trying to push their way through the gums, 
but simply signalizes the development of the 
salivary glands and the further development 
of the function of digestion. 

Many mothers and nurses regard the teeth- 
ing period as a time to be dreaded and a 
time when the baby is sure to be sick. This 
is a mistake. It is perfectly natural for the 
baby to have teeth and there is nothing what- 
soever to fear from the process. In a nor- 
mal baby the teeth usually appear between 
the seventh and tenth months. The first teeth 
44 



TEETHING 



45 



are known as the milk teeth and are twenty 
in number. The following table will show the 
usual rule followed by normal dentition in 
the average baby: 



19 


II 


13 


5 


3 1 4 


6 


14 


9 


17 


20 


12 


15 


7 


1 | 2 


8 


16 


10 


18 



i and 2 are the lower incisors, usually first 
teeth; then follow 3 and 4, the upper inci- 
sors. Normal children usually teeth in pairs 
and not singly, whereas rachitic children 
usually have an eruption of single teeth. As 
a rule there is a lapse of from three to twelve 
weeks between the appearance of each group. 
Some infants do not show teeth before the end 
of the first year. This is usually due to the 
fact that they are not well nourished. The 
physician should be consulted for a change 
of diet. Infants reared by bottle-feeding do 
not cut teeth as early as those nourished by 
healthy breast-milk, although rachitic infants 
sometimes teeth very early. 

The restlessness, loss of appetite, slight 
fever and putting of fingers in the mouth so 
frequently attributed to teething, are more 
often due to faulty feeding. When the gums 
are very red and swollen and baby seems really 
to suffer, ask the doctor to examine the gums 



46 THE HEALTH-CARE OF THE BABY 

and he will order a cooling lotion. Lancing of 
the gums is rarely necessary. A piece of ice 
wrapped in sterile cheesecloth, and held on the 
gnms is soothing, or absorbent cotton may be 
saturated with five drops of paregoric and be 
gently rubbed on the gums. Frequent sips 
of cool water are comforting to the baby if 
the gums are hot. If the baby is comforted 
by biting on a hard substance, a piece of 
zwieback is preferable to the rubber or ivory 
ring so commonly used. If the baby's vital- 
ity seems lowered during the teething period, 
which is shown by slight fever, restlessness, 
undigested food in the stools or vomiting, then 
a weaker food should be given. If the baby 
is breast-fed give him one or two ounces of 
filtered water before each nursing and reduce 
the length of nursing five minutes. If bottle- 
fed, take from each bottle one or two ounces 
of milk and add the same amount of filtered 
water. When all signs of restlessness have 
disappeared the food can gradually be strength- 
ened. Backwardness in teething is chiefly 
due to lack of phosphates and an absence of 
lime salts in the food. Cereals such as oat- 
meal, farina, hominy, arrowroot or cornstarch 
should be given once or twice a day. Steak- 
juice may also be tried. 



PART II 

Infant Feeding 



CHAPTER I 
GENERAL FEEDING 

EACH baby is a law unto itself, and its 
individual wants must be studied. One 
baby will gain on the same mixture on which 
another will lose weight. The proof of the 
proper assimilation of food in any and every 
infant will be the following: An infant must 
appear satisfied after taking its bottle. There 
should be no vomiting or severe colicky pains. 
The bowels must move (unaided) at least 
once or twice in every twenty-four hours. The 
stools should be yellowish- white, and medium 
soft. The infant should sleep from four to 
eight hours during the night without awaken- 
ing. 

The weight must be taken regularly once 
a week. If an infant thrives it should gain 
from four to eight ounces every week, until the 
sixth month after which time it should gain 
from two to four ounces each week. If the 
weight shows no increase by all means con- 

49 



50 THE HEALTH-CARE OF THE BABY 

suit your physician that he may give more 
substantial food. 

The natural method of feeding a baby is 
by means of the human breast. If this were 
not so then every woman would simply pass 
through her period of pregnancy and the 
breasts would not secrete milk. Breast milk 
contains in addition to nourishment certain 
antitoxic bodies. These substances usually 
prevent a child from taking the acute infectious 
diseases. To produce this immunity from 
disease is in itself sufficient compensation for 
the arduous duties demanded of a nursing 
mother. 

There are times when the breast milk is de- 
ficient in quantity. At such times we should 
always make use of what little breast milk 
is present and supply the deficiency by giving 
the bottle, 
water. Every child, young or old, must receive 

water several times a day. It will aid ma- 
terially in clearing the mouth and gums and 
in quenching thirst. An infant up to the first 
month should receive several teaspoonfuls of 
plain filtered water either immediately after 
nursing or feeding or as soon after feeding 
as possible. It is not necessary to awaken 
the child in order to give it a drink. If it is 



GENERAL FEEDING 5 1 

not time for feeding and the infant is restless, 
a few spoonfuls of cool water will frequently 
quiet it. When we desire to modify consti- 
pation, then water will be a most important 
factor, especially so when large, cheesy curds 
are found in the stool. 

Recent studies with human milk have 
shown that the greatest number of infants owe 
their dyspepsia, with its train of symptoms 
such as colic, flatulence, eructations and 
vomiting to overfeeding. 

This overfeeding is due to too frequent in- 
tervals of feeding. Whereas the old rule of 
feeding every two hours has been used, ex- 
perience has demonstrated that it is wiser to 
substitute an interval of at least three to four 
hours, and so give no more than five, rarely 
six feedings in 24 hours. We also gain there- 
by an interval of rest for the mother which 
seems to relieve her of the overstrain by too 
frequent nursing. 



CHAPTER II 
BREAST FEEDING 

THE first three or four days after birth 
require special feeding methods: 
The first substance secreted in the breasts 
is known as colostrum. This is thinner than 
milk and very scant. The exhaustion of the 
mother beside the normal deficient quantity 
of food in the breasts, demands long inter- 
vals of rest; thus for the first three days put- 
ting the baby to the breast once every four 
to six hours would be sufficient. If, how- 
ever, the supply of milk is ample then we can 
follow the table on page 53 and feed the baby 
every three hours, 
interval During the first month the baby should be 

During 

Day. fed every three hours during the day, never 
oftener; and during the second month the 
same interval should be maintained. The 
baby may be taken from his sleep during the 
day to be nursed. 

Do not disturb the baby from his sleep at 
night to be nursed. Let him rest as long as 
52 



BREAST FEEDING 



S3 



From Birth 

to 3 
Months Old. 


3 to 8 Months 
Old. 


8 Months Until 
1 Year Old. 


6 A.M. 


6 a.m. 


6 A.M. 


9 A.M. 

12 Noon 


9:30 A.M. 
I P.M. 


10 A.M. 
2 P.M. 


3 P.M. 
6 P.M. 
9 P.M. 

12 Midnight. 


4:30 P.M. 
8 P.M. 

12 Midnight. 


6 P.M. 
IO P.M. 



he appears satisfied. This applies to healthy 
infants only. In sickness special feeding rules 
are required. If the baby thrives and gains in 
weight, it is better for both mother and baby 
to have an interval of rest and skip a nursing 
or two after midnight. If the baby is restless 
during this interval, change his position and give 
him one or two teaspoonfuls of boiled water. 

The mother or wet-nurse should always How to 

ii,i. Hold tlie 
sit upright while nursing the baby, be it at Baby 

night or during the day. If the baby is Nursing. 

nursing from the left breast, he should be 

held on the left arm while the right hand 

presses the breast away from the baby's nose, 

but without pulling the nipple from his mouth. 

This will give him plenty of air to breathe so 

that he must not let go of the nipple to breathe. 



54 THE HEALTH-CARE OF THE BABY 

When there is nasal obstruction such as ca- 
tarrh, or when post-nasal obstruction exists, 
such as adenoids, then an infant will let go 
of the nipple in order to draw a breath. 
length No infant should nurse longer than twenty 

of Nursing ° J 

Act - minutes, whereas frequently ten or fifteen 

minutes will suffice. Do not allow the baby 
to fall asleep while nursing. If this is allowed 
he will not get all the nourishment he should 
have. Light taps on the cheek of the baby 
will waken him, or the withdrawal of the 
nipple from his mouth will frequently arouse 
him to continue nursing. If, however, he 
will not renew his nursing, and has already 
nursed ten minutes, then the sleep should not 
be disturbed. 

Do not allow him to take his meal too 
rapidly as he is liable to have an attack of 
hiccup or to regurgitate his food. If the 
baby nurses too rapidly withdraw the nipple 
from his mouth for a few seconds. This may 
be done every three or four minutes. 

As a rule the baby should nurse from but 
one breast at each meal, if, however, there 
is not enough milk in one breast, then both 
breasts may be given. 

Diet of a A nursing woman should have three meals 

Nursing ° 

Woman. a ^ a y # These meals should be simple but 



BREAST FEEDING 55 

nutritious and mostly liquid. Meat should 
be taken only once a day. Milk, eggs, cereals 
and soups should form the principal part of 
the diet. For thirst, cool, filtered water or 
alkaline waters, like seltzer or apollinaris, 
should be taken. 

If the milk is scanty, the flow can be stimu- Scanty 

Milk. 

lated by drinking a cup of hot broth, weak 
tea, cocoa, milk or gruel several minutes be- 
fore putting baby to the breast. Foods to Food 

r & J Prohibited 

be avoided by a nursing woman, are: Onions, 
garlic, cabbage, ethereal oils and sour fruits. 

The return of menstruation is no contra- Menstm- 

t , r . ation. 

indication to the continuation of nursing. 
In nearly all cases the quality of milk will be 
affected to such a degree as to cause slight 
disturbances of digestion, such as restlessness 
or colic, or some bowel derangement. If the 
baby continues to gain in weight nursing may 
be continued. If there is too much distur- 
bance, diluted cows' milk should be given 
during the first two or three days of men- 
struation. 

No woman should attempt to nurse a baby constitu- 

. . r i t • i i. • tional 

who is not sure of her physical condition. Disease. 
Tuberculosis, hereditary nervous troubles, 
epilepsy, syphilis and all chronic disorders 
and diseases would prevent proper nursing. 



CHAPTER III 
WEANING 

BY weaning a breast-fed baby we mean 
gradually taking from him the breast- 
milk by which he has been nourished since 
birth, and giving him cows' milk and other 
forms of nourishment. 

By weaning a bottle-fed baby we mean 
gradually substituting for all cows' milk other 
nourishment such as raw eggs, soups, broths, 
and gruels. 

A normal baby is usually weaned between 
the eighth and tenth months. In some in- 
stances it is advisable to begin earlier, for 
example, when there is a deficiency in the 
quantity of breast milk owing to the ill health 
of the mother. Sometimes there are reasons 
why the baby should be nursed twelve months 
and longer so that it should always be left to 
the judgment of the physician when the baby 
would be weaned. 

My rule has been not to wean during the 
56 



WEANING 57 

summer months, although it is imperative to 
do so if the infant's mother become pregnant. 
Weaning should not be attempted suddenly. 
It is better to commence by the breast in the 
morning and substituting a bottle for the next 
feeding. Following this meal we can again 
nurse the baby at the breast and substitute a 
bottle for its fourth meal. 

6:00 a.m Breast 

10 :oo a.m Bottle 

2 :oo p.m Breast 

6:oo p.m Bottle 

1 1 :oo p.m (If awake) Breast 

Care must be exercised in making this 
change of diet, as the slightest error in over- 
feeding or too frequent feeding will be re- 
warded by a severe attack of dyspepsia and 
the usual gastric disturbances, such as vom- 
iting and fermentation in the stomach, causing 
diarrhea and colic. 

If baby has been taught from birth to drink 
water from a bottle there should be no trouble 
while weaning him in having him drink his 
milk from the bottle. If it is impossible to 
make him drink from a bottle feed him from 
a spoon or let him drink from a cup. Some 
babies learn to drink from a cup when six or 



58 THE HEALTH-CARE OF THE BABY 

seven months old. It is better to have a 
strange nurse feed baby while weaning him 
and keep the mother or wet nurse away so 
he can not see the breast and be reminded of 
the breast feeding. 



CHAPTER IV 

MIXED FEEDING 

WHEN the breast-milk is of good quality, 
but the quantity is deficient, and the 
baby does not thrive and seems to cry from 
hunger, it is necessary to give him some addi- 
tional food. This is usually done by giving 
baby alternate feedings of breast-milk and 
cows' milk. / 

The mother or wet-nurse should try to im- 
prove both quality and quantity of her breast- 
milk by building up her general condition. 
Frequently a subnormal or anemic condition 
requires an iron tonic. In other cases a day's 
outing to the country or seashore, with mode- 
rate exercise will stimulate the flow of milk. 

As cows' milk is more difficult to digest than 
breast- milk, it must be given well diluted; 
therefore, give the baby the amount in the 
formula provided for a baby who is one month 
younger. For example: If the baby is four 
months old when you start the mixed feeding, 
give him of the formula of cows' milk that a 
baby three months old would receive and 
gradually increase until the formula for a 
baby of his age is given. 
59 



Milk. 



A 1 



CHAPTER V 

ARTIFICIAL FEEDING 

LL American mothers cannot nurse their 
infants. A sick mother, a tuberculous 
mother, or a very nervous mother is frequently 
prevented from nursing her baby through her 
systemic weakness. In some instances human 
milk may be necessary to save the life of a 
weak infant or one that has been improperly 
managed. A wet nurse can be secured and it 
is in many cases a life-saving substitute. A 
wet nurse should never be selected without 
the supervision of a physician. Her blood 
must always be tested for syphilis before per- 
mitting the baby at her breast. The large 
majority of American mothers resort to the 
usual method of artificial feeding by using 
cows' milk adapted for the age and require- 
ments of the infant's digestion. 
cows' The best cows' milk for infant feeding is 

sold in New York City at milk dairies under 
the name of certified or guaranteed milk. 
When certified milk can be obtained, then we 
60 



ARTIFICIAL FEEDING 6 1 

have reached as near perfection as is possible 
to-day under strict municipal control. All 
milk, whether certified or not, should be heated 
until steam rises and kept steaming (not boil- 
ing) fifteen minutes. This safeguard will kill 
disease germs and render the milk safe for 
infant feeding. Such milk is called pasteur- 
ized milk. 
Milk for baby's feeding should be kept near To Pre- 

serve Ivlillsr 

the ice in a separate compartment of the re- for Feed- 
frigerator, or better still in a nursery refrigera- 
tor, in which nothing but baby's food is kept. 



CHAPTER VI 
BOTTLE FEEDING 

Re e ukld nPHE following utensils are required for the 
A modification of milk at home: A two- 
quart pitcher; funnel, (glass or porcelain); 
one large spoon; one dozen 4-ounce bottles, 
(later 8-ounce bottles); one dozen anti-colic 
nipples; one box non- absorbent cotton; one 
large saucepan (for heating milk); one high 
saucepan (for warming bottles before feed- 
ing); one dairy, or pasteurizing thermome- 
ter. 

The The Ions:, round feeding-bottle is the best 

Bottles. & ' & 

of all feeding-bottles. It is smooth on the 
inside, has no corners or angles, and can be 
easily cleaned. On the outside the graduated 
ounces are marked. 
Care of As soon as baby has emptied the bottle it 

the Bottles 

and should be cleaned with a bottle brush in clear 

Nipples. 

hot water, then filled with fresh water and 
set aside. In the morning before the day's 
food is prepared all the bottles should be 
boiled in a solution of baking soda and water, 
62 



BOTTLE FEEDING 63 

two teaspoonfuls of soda to one quart of 
water. The bottles should then be rinsed 
thoroughly in clear boiled water. 

The nipples should be cleaned in the same 
way as the bottles and when not in use should 
be wrapped in dry sterile cheese-cloth and 
placed in a covered jar. 

When the source of the milk is unknown h™ to 
and we are not familiar with dairy methods, ' ' 
the safest plan is to heat the milk in a double 
boiler until the steam rises, and continue heat- 
ing at this same temperature for fifteen min- 
utes. We can also subject the milk to the 
steaming process by using a pasteurizer and 
steaming the milk about fifteen minutes. Milk 
should never be sterilized or boiled. 

The first evil result noticed while using fttriifcL 
sterilized milk is that children so fed are con- tlon ' 
stipated. Prolonged use of sterilized milk 
results in rickets. There are many cases of 
scurvy that can be traced to a long-continued 
use of sterilized milk. 



CHAPTER VII 
HOME PREPARATION OF INFANT FOOD 

Bottle A CHILD in good health, with excellent 

forY /"*. digestion, and normal stools, may be fed 
Baby. on m iik diluted with barley water. If a tend- 
ency to constipation exists then oatmeal water 
instead of barley water should be used. My 
plan has been to order the milk diluted with 
barley water on one day, and oatmeal water 
on the following day. In summer if a ten- 
dency to loose bowels is noted, then milk di- 
luted with rice or barley water should be fed. 
stomach No set rule can be given for all infants. 
Each infant's requirements must be studied. 
The size of the stomach varies in infants. 
The stomach capacity of one infant may be 
six ounces at the age of two months, while 
another equally healthy infant will have a 
capacity of and be satisfied with four ounces 
at one feeding. These individual peculiari- 
ties must be taken into consideration when es- 
timating the quantity of food for each meal. 
We cannot feed all infants at the same in- 
tervals. What applies to the quantity applies 
6 4 



INFANT FOOD 65 

also to the frequency of feeding. One infant 
will thrive on a meal every three hours, an- 
other infant requires a feeding every two 
hours. Here again it is necessary to study 
the individual requirement, and be guided by 
the amount of rest, by the stool, and by the 
gain in weight. The tendency of the mother 
is to overfeed, which is harmful. 

Formula No. i (for an infant from birth to Food for 

a v \ the First 

one month) : Month. 

Pasteurized milk 4 ounces 

Barley water l 16 ounces 

Maltose 2 1 ounce 

(or 2 level tablespoons) 
Divide into 8 bottles of 2 J/£ ounces each and 
feed every three hours. 

Formula No. 2 (for an infalnt from one to Food for 

two months) : second 

Pasteurized milk 7 ounces Month. 

Barley water 20 ounces 

Maltose 1 J^ ounces 

(or 3 level tablespoons) 
Divide into 7 bottles, each bottle containing 
about 4 ounces, and feed every three hours. 

Formula No. 3 (for an infant two to four Food for 
months): _ $ e on ^! rd 

Pasteurized milk 10 ounces 

Barley water. 19 ounces 

Maltose i}4 ounces 

(or 2 tablespoons and 1 teaspoon) 
Divide into 6 bottles, containing about 5 
ounces, and feed every three and one-half 
to four hours. 

1 For making rice water, barley water and other diluents, see 
the chapter on Food Recipes. Page 81. 

2 Maltose is a malt-sugar, which can be purchased in any drug 
store. I advise the use of Loefflund's Maltose or Mead's Dextri- 
Maltose. 



66 THE HEALTH-CARE OF THE BABY 

Food for Formula No. 4 (for an infant from four to 

the Fourth . . i \ 

and Fifth six months) : 

Months. 

Pasteurized milk 15 ounces 

Barley water 14 ounces 

Maltose 1 H ounces 

(or 3 tablespoons) 
Divide into 5 bottles, each bottle containing 
about 6 ounces, and feed every four hours. 

Food for Formula No. 5 (for an infant six to nine 

the Sixth, * - N 

seventh months) : 

and J 

Eighth Pasteurized milk 26 ounces 

Months. Barley water 12 ounces 

Maltose 1 % ounces 

(or 3 tablespoons and 1 teaspoon) 
Divide into 5 bottles, each bottle containing 
about 7 to 8 ounces, and feed every four 
hours. 

Food for Formula No. 6 (for an infant from nine to 

the Ninth, . N 

Tenth, twelve months) : 

Eleventh 

T nd lfth Pasteurized milk 32 ounces 

Months. Barley water 4 ounces 

Maltose 1 % ounces 

(or 3 tablespoons and 1 teaspoon) 
Divide into 4 bottles, each bottle containing 
9 ounces, and feed every four hours. 

Dissolve the maltose in the hot barley water 
and add the pasteurized milk. Fill and cotton 
stopper the bottles and place in the refrigerator 
but not on the ice. At feeding time warm to 
feeding temperature by placing the bottle in 
hot water, then remove the cotton stopper and 
draw on the nipple. 

TOP-MILK FEEDING 

In using top milk for infant feeding the milk 
is allowed to stand in a quart bottle at a tern- 



TOP-MILK FEEDING 67 

perature of 45 to 50 F. for the same length 
of time as when gravity cream is desired — 
five hours — when the quantity needed is 
removed from the top of the bottle with a 
Chapin dipper and diluted, as desired, with 
water or gruel to which maltose and lime 
water are added. 

From a quart bottle of pasteurized milk on 
which the cream has risen, dip from the top 
sixteen ounces and mix. From average milk 
this should contain: 

7.0 per cent, fat 

3.2 per cent, sugar 

3.2 per cent, total solids 

TOP-MILK FORMULAS FOR VARIOUS AGES 

From the third to the tenth day: 

Pasteurized milk (top 16 oz.). 3 oz. Maltose K oz. 

Lime water K oz. Water to make 16 oz. 

Eight feedings in 24 hours ; 1 to 1 Y2 ounces every 3 
hours. If baby cries from hunger, feed every 2% 
hours. 

From the tenth to the twenty-first day: 

Pasteurized milk (top 16 oz.). 6 oz. Maltose 2< oz. 

Lime water \yi oz. Water to make 24 oz. 

Eight feedings in 24 hours; 1 3^2 to 2 ounces every 
2 3^ to 3 hours. 

From the third to the sixth week: 

Pasteurized milk (top 16 oz.). 10 oz. Maltose 1 oz. 

Lime water zy 2 oz. Water to make 32 oz. 

Seven feedings in 24 hours; 2 to 3 ounces every 2^ 
to 3 hours. 



68 THE HEALTH-CARE OF THE BABY 

From the sixth week to the third month: 

Pasteurized milk (top 16 oz.). 12 oz. Lime water 3 oz. 

Maltose 1 oz. Water to make 32 oz. 

Six feedings in 24 hours; 2j^ to 4 ounces every 3 to 
3^ hours. 

From the third to the fifth month: 

After this age two bottles of milk are required, six- 
teen ounces being taken from the top of each bottle 
and mixed. 

Pasteurized milk (top 16 oz.). 18 oz. Lime water 4 oz. 

Maltose 1 oz. Water to make 40 oz. 

Six feedings in 24 hours; 4 to 5 ounces every 3 3^ 
hours. 

From the fifth to the seventh month: 

Pasteurized milk (top 16 oz.)- 21 oz. Lime water 5 oz. 

Maltose 1 oz. Water to make 42 oz. 

Five feedings in 24 hours; 5 to 7 ounces every 3^ 
to 4 hours. 

From the seventh to the ninth month: 

Pasteurized milk (top 16 oz.). 27 oz. Lime water 6 oz. 

Maltose \% oz. Water to make 48 oz. 

Five feedings in 24 hours; 6 to 8 ounces every 4 
hours. 

From the ninth to the twelfth month: 

Pasteurized milk (top 16 oz.). 35 oz. Lime water 6 oz. 

Maltose iK oz. Water to make 56 oz. 

Four feedings in 24 hours; 7 to 9 ounces every 4 
hours. 

Mix top milk, maltose and lime water. Steam ten 
minutes, then divide into the required number of 
feedings. 

After the twelfth month undiluted milk may be 
given. 



CHAPTER VIII 
FEEDING A DYSPEPTIC BABY 

IF the baby's stool contains curds or green- 
ish masses and if the baby is restless at 
night and colicky by day, then the following 
feeding will be advisable: Take of raw milk, 4 
ounces; barley water, 4 ounces, and peptogenic 
milk powder, 3^ measure. Heat slowly with 
constant stirring until it comes to a boil. 

If after three days in spite of this pepto- 
nizing milk powder being added, curds are 
still seen in the stool, then stop milk feeding 
and give: barley water, 4 ounces; lime water, 
1 teaspoonful; maltose, 1 teaspoonful; white 
of one raw egg. Feed every three or four 
hours. In preparing this formula dissolve the 
maltose in the barley water and add the lime 
water. At feeding time warm the bottle and 
add the white of one raw egg and mix by 
shaking the bottle. 

If persistent vomiting and green stools are 
present, then use from 4 to 6 ounces of sweet- 
ened whey. If the bowels are loose as in 
69 



70 THE HEALTH-CARE OF THE BABY 

summer complaint, and the stools are watery, 
give i teaspoonful of top milk to a teacupful 
of barley water, boil five minutes and feed 
when lukewarm. 

If diarrhea continues in spite of the above 
method of feeding, then give of barley water, 6 
ounces; lime water, i teaspoonful; baked flour 
(see page 85), 1 teaspoonful; maltose, 1 
teaspoonful. Feed every 4 hours. Mix flour 
and sugar with the barley water, add lime 
water, boil five minutes and feed when luke- 
warm. 
Feeding When vomiting persists it is advisable to 

vomiting give the stomach absolute rest and still give 

Persists. ■ ° 

enough food to sustain life. 

Until a physician can be consulted, give 
condensed milk Y2 teaspoonful and 4 ounces 
hot water every three or four hours. 



CHAPTER IX 

SKIMMED MILK FEEDING. PEPTONIZED MILK 
FEEDING 

{Predigested Milk for a Baby with Weak Digestion.) 

WHEN fever is high or when the stomach |^ med 
is weak, skimmed milk should be used. 
Likewise when vomiting persists and a weak 
food is required, skimmed milk should be 
given. As a rule the same formula can be 
given, substituting skimmed milk for the 
whole milk. 

To make skimmed milk place a quart bottle 
of milk in a refrigerator for three hours, then 
skim off the cream; the remainder, which is the 
skimmed milk, is to be used. 

Curds when present in the stool of angled 
infant, if small and round and lentil shaped, 
are known as fat curds. They are as a rule 
caused by "fat indigestion " due to the 
formula containing too much cream or fat. 
Other curds very large and coarse are usually 
saponified fat, or casein or cheese curds. 

Peptonizing powders are digestive agents 
sold in glass tubes or in tablet form. They 
7i 



72 THE HEALTH-CARE OF THE BABY 

are composed of pancreatin and bicarbonate 
of soda. Another predigesting powder sold in 
drug stores is know by the name of pepto- 
genic milk powder. 
Miik onized T ^ e contents of a peptonizing tube should 
be added to a tablespoonful of cold water, and 
a quart of cold milk slowly added. Place 
this bottle of milk containing the powder in 
a kettle of warm water, temperature about 
no° F., leaving it there for ten minutes. 
This peptonizing powder will partially predi- 
gest the milk. The milk must then quickly 
be brought to the boiling point, and placed 
in a cool place. 
indigestion a curded stool containing white, cheesy 
stool 7 particles is usually found in dyspeptic dis- 
orders affecting the stomach and bowels. 
When peptonized milk has been used such 
curds must disappear and the stool assume 
a yellowish condition. When improvement 
is noted the use of the peptonized milk should 
be continued for several months, so that the 
weakened stomach and intestines may be re- 
stored to their normal, healthy state. If im- 
provement is not noted and curds continue to 
appear in the stool, then a complete change 
of food must be made. Milk in every form 
must be stopped. This will give the stomach 



PEPTOGENIC MILK POWDER 73 

a complete rest. As a substitute we can feed 
sweetened rice water or barley water, to which 
the white of a raw egg is added. Such feeding 
must be continued for several days but only 
under the guidance of a physician. 

When cows' milk disagrees in spite of being Pepto- 
diluted with plain water, rice water, barley Miik 

^ ' ' J Powder. 

water or oatmeal water as previously men- 
tioned, then the addition of peptogenic milk 
powder will alter the ingredients of the milk 
and render it more digestible. 

The screw cap on the peptogenic milk bot- 
tle is also a measure. To an eight-ounce 
bottle of raw milk slowly add with constant 
stirring, one-half measure (screw-cap) of pep- 
togenic powder, heat slowly for ten minutes 
over a small flame or to a temperature of 
1 1 5 F; then cool to feeding temperature. 
A more rapid method and one preferred by 
me is as follows: Take of raw milk, 2 ounces; 
hot water, 2 ounces; peptogenic milk powder, 
\i measure. Dissolve the peptogenic powder 
in the hot water, add the raw milk, heat to 
feeding temperature and feed. By this pro- 
cess each bottle is prepared separately. The 
milk does not acquire a bitter taste and the 
curd is partially digested, which is a decided 
necessity for the weak stomach of an infant. 



CHAPTER X 
PROPRIETARY INFANT FOODS 

THE market is filled with a large number 
of patent infant foods. This proves that 
there is a demand for something in addition 
to methods of feeding in vogue at the present 
day. Physicians as a rule condemn the use 
of these foods and chiefly for the following 
reasons : 

First. Because the laity, except in rare 
instances, are not competent to feed an in- 
fant by following directions on the label of a 
box of food. No shoe is made that will fit 
every baby's foot, and no infant food made 
will agree with and be properly assimilated 
and digested by every baby. It is a well- 
known law that individualization is more de- 
manded in infant feeding than in any other 
method of treatment. The digestive func- 
tions are totally different in various individ- 
uals, and so it must be left for the intelligent 
physician to note the size of the body to be 
fed, study the infant's wants, note the condi- 

74 



PROPRIETARY £OOt)S 75 

tion of his digestive apparatus and, last but 
not least, the stool must be properly examined. 
Then and not until then can any one prescribe 
the kind of food, the amount of food and the 
feeding interval demanded. 

Second. No greater mistake is made than 
to suppose that because an infant has gained a 
few ounces and is gaining continuously, he is 
in absolute good health. When a large amount 
of starch or transformed starch, such as dex- 
trinized starch, is fed to an infant, or when 
large quantities of sugar are given, there is 
usually a notable increase in weight. Bone 
and muscle, which are formed chiefly by the 
proteid element of food, cannot be replaced 
by the carbohydrate or fat forming substances. 
The ambition of many mothers and nurses 
is to display with pride a big fat baby and 
show large gains in weight. To accomplish 
this, frequently proprietary foods have been 
added in very large amounts, thus overtaxing 
the digestive apparatus and ending in dyspep- 
tic or enlarged stomachs. 

Having pictured the dangers it is but fair to A dvan- 
state that there are very many virtues in these Propril 
proprietary foods. I advise the use of many Foods. 
of these foods in infants six months old or 
older, especially for those requiring additional 



76 THE HEALTH-CARE OF THE BABY 

food during the period of dentition. To the 
formula of milk and barley water previously 
given, add one teaspoonful or more of Mellin's 
food or malt soup to each feeding. When a 
tendency to constipation exists Mellin's food 
or malted milk are especially indicated. Hor- 
lick's food is a food which, like Nestle's food, 
requires no milk, but only the addition of 
water. If milk is overheated, as it is when 
subjected to sterilization or prolonged pasteur- 
ization, then a decided constipating tendency 
usually results. To prevent constipation by 
using these foods, milk or diluted milk should 
be simply pasteurized or steamed five minutes. 
When milk is boiled, constipation, due to the 
altered condition of the casein (curd), results. 



CHAPTER XI 
FEEDING DURING DIARRHEAL PERIOD 

WHEN mucus continues to be present and 
the stools are thin, then milk in every 
form must be stopped. It is in this class of 
cases that even whey will not be tolerated. 
This form of diarrhea usually occurs in sum- 
mer when milk has undergone fermentative 
changes due to the presence of bacteria. As 
a temporary substitute feeding, intending to 
correct looseness, I advise the following : Nes- 
tle's food, i teaspoonful; rice water, 3 ounces. 

Rub up the Nestle's food powder with a 
little cold water, add the rice water and heat 
slowly until it comes to a boil. Do not add 
sugar or lime-water. The above quantity can 
be fed every three hours to a baby up to three 
months of age. 

For a child 3 to 6 months of age give every 
3! hours: Nestle's food, i| teaspoonfuls ; 
rice water, 5 ounces. For an infant 6 
to 9 months of age give every 4 hours : 
Nestle's food, 2 teaspoonfuls; rice water, 7 
ounces. 

77 



78 THE HEALTH-CARE OF THE BABY 

If this form of feeding is carefully prepared 
and the utensils are properly cleaned, then 
we must adhere to a proper feeding interval. 
An infant with loose bowels should be fed 
once in three hours and fed very slowly. Un- 
less we adhere to the proper feeding interval 
and give the infant an interval of rest, we can 
excite diarrhea by too frequent feeding. A 
sympathetic mother will frequently indulge 
her baby and feed too frequently, thus stimu- 
lating the bowels by too much liquid food. 
For an infant 6 months old the addition of 
i teaspoonful of Mellin's food to 4 ounces 
of milk and 4 ounces of barley water has 
served me very well to correct a tendency to 
very thin stools. 

To correct loose, foul-smelling stools con- 
taining mucus give a teaspoonful of castor oil ; 
two hours later begin feedings of four to six 
ounces of skimmed milk, without sugar. To 
make skimmed milk place a quart bottle of 
milk in a refrigerator for three hours, then 
skim off the cream; the remainder, which is 
the skimmed milk, is to be used. 



CHAPTER XII 

DIETARY 

FOR A CHILD FROM TWELVE TO 
EIGHTEEN MONTHS OLD 

Use pasteurized milk or milk steamed five minutes 

6a.m. ]%/| ILK, 8 ounces. 

9:30 A.M. !▼*• Steamed oatmeal, farina, hominy, 
cream of wheat or arrowroot. 
One piece zwieback or toast. 
Milk, 6 ounces. 

12:30P.M. Beef or chicken broth 4 to 6 ounces, thick- 
ened with farina, sago or fine home-made 
noodles, or one ounce expressed beef juice 
with toast crumbs. 

a : 3 o p.m. Milk, 8 ounces. 

One piece zwieback. 

4:30 P.M. When out of doors, or if constipated, may 
have: apple sauce, prune pulp or juice of one 
orange. 

6p.m. Milk, 8 ounces. 

io-n p.m. If restless, may have milk, 8 ounces. 

FOR A CHILD FROM EIGHTEEN MONTHS 
TO TWO AND ONE-HALF YEARS OLD 

6-7A.M. Milk, 8 ounces, with Mellin's food, 2 tea- 
spoonfuls. 

79 



8o THE HEALTH-CARE OF THE BABY 

One piece zwieback or Huntley & Palmer 
biscuits. 
qa.m. Juice of one orange. 

10A.M. Steamed farina, oatmeal, hominy, cream of 

wheat, or arrowroot, or a soft boiled or 
poached egg. 
Milk, 6 ounces. 
12:30 P.M. Beef or chicken broth thickened with sago, 
rice or farina, clear broth with yolk of egg, or 2 
ounces of expressed beef juice. 

Baked potato, spinach, carrots, peas, beets, 
asparagus, or stewed celery. 

Stewed prunes, stewed figs, baked apple or 
apple sauce. 

Huntley & Palmer biscuits, graham wafers, 
Albert crackers or lady fingers. 
Water. 
3:30 P.M. Cup of milk and a cracker. 
6:30P.M. Soft boiled egg, junket, custard, cornstarch, 
tapioca, or farina pudding. 

Sliced banana or raw scraped apple. 
Cup of milk or cocoa. 

FOR A CHILD OVER THREE YEARS OLD 

7:30A.M. Yellow Indian meal, cream of wheat, oat- 
meal, force, puffed rice, or shredded wheat. 

Soft boiled or poached egg, if appetite 
warrants it. 



I2:.30P.M. 



3:30 P.M 



DIETARY 8l 

Graham or whole wheat bread or toast. 

Cup of milk. 

Chicken or beef broth thickened with 
farina, rice, barley or home-made noodles, or 
one ounce expressed beef juice over baked 
or mashed potato. 

Broiled lamb chop, steak, fresh mackerel, 
halibut, trout, squab, or roast beef. 

Spinach, peas, beans, carrots, asparagus, 
corn, tomatoes, celery. 

Stewed figs, peaches or apples. 

Water, liberally. 

Crackers with fruit jam. On cold days a 
cup of hot malted milk (4 teaspoonfuls Hor- 
lick's malted milk to 1 teacup hot water) or a 
cup of cocoa. 

Scrambled egg, cornstarch pudding, or 6:30 p.m. 
custard, Philadelphia cream cheese, macaroni 
or noodles. 

Cup of cocoa or milk. 

All fresh fruits in season. 

Bread and butter. 

FOOD RECIPES 

To make barley water add one tablespoon- Barley 
ful of pearl barley to one quart of cold water, 
boil two hours, adding water from time to time. 
Strain through muslin and add enough boiled 



82 THE HEALTH- CARE OF THE BABY 

water to make one quart. When the barley 
flour is used mix two teaspoonfuls of the flour 
in a little cold water, add one quart of water 
and boil fifteen minutes. Strain through 
muslin if there are any lumps, and add enough 
boiled water to make one quart. 

Water -^ ce water * s raade in the same manner as 

barley water, one tablespoonful of rice being 
used to one quart of water. When rice flour 
is used, add two teaspoonfuls to a quart of 
water. 

oatmeal Oatmeal water is made in the same manner 

VV ater. 

as barley water. Use one and one-half table- 
spoonfuls of oatmeal to one quart of water. 

Gmeis. Gruel is made by adding two teaspoonfuls 

of rice flour, barley flour or oatmeal to one 
pint of cold water, and boiling briskly for 
one-half hour. Add a pinch of salt and a 
teaspoonful of granulated sugar. 

Albumin To make albumin water add the white of 

Water. 

one raw egg to one-half pint of water. Pour 
the egg and water into a clean bottle and shake 
well, Feed through a nipple or by spoon. 
Nutritious A nourishing drink is made by adding the 
ade. juice of half a lemon to the yolk of a raw egg; 

let it stand for five minutes, and then add two 
teaspoonfuls of granulated sugar and five 
ounces of water. 



DIETARY 83 

Beat the white of one raw egg with one Nutritious 

00 Orangeade. 

teaspoonful of granulated sugar and add the 
juice of one orange and five ounces of water. 

Take one-half pint of fresh cows' milk and J" n ^t 
heat it lukewarm (about ii5°F); add one 
teaspoonful of Fairchild's essence of pepsin 
and stir just enough to mix. Pour it into 
cups and let it stand in a cool place until 
firmly curdled. Serve plain or with a little 
sugar. 

Curdle warm milk with the essence of pep- Whey, 
sin as directed in making junket. After the 
milk has curdled or clotted beat up the curd 
with a fork and strain it. The liquid is the 
whey which may be sweetened by adding one 
teaspoonful of maltose. 

Expressed beef juice is obtained by slightly Beef 
broiling a piece of lean beef, and squeezing 
the juice from it with a lemon squeezer or a 
meat press. One pound of steak yields from 
two to four ounces of juice. Flavor it with 
a little salt and slightly warm it by standing 
a cup containing the beef juice in a bowl of hot 
water. 

Take one pound of lean mutton, veal, beef Broths. 
or chicken, including some of the bone, a 
sprig of parsley and a blade of celery for one 
quart of cold water containing a pinch of 



84 THE HEALTH-CARE OF THE BABY 

salt. Cook slowly for three hours, strain 
through muslin and remove the greater part 
of the fat. 
very Weak, cold tea (English Breakfast) made 

Thirst 1 " ^ steeping about three tea leaves in one cup 
of boiling water for two minutes, is very valu- 
able to quench thirst in a baby suffering with 
diarrhea. Two or three teaspoonfuls may 
be given at one time and repeated every half- 
hour. Besides the cooling effect tea has a 
decided astringent property which makes it 
valuable in diarrhea. 
Gelatin A delicious dessert for a child two years old 

Pudding, ■* 

or older is made with gelatin powder and 
hot water. Cox's, Knox's, or Price's gelatin 
powder may be used. The directions for the 
proper proportion of powder and water will be 
found on each label. 

Custard Beat together one fresh egg and a teaspoonful 

of granulated sugar; pour into a cup and add 
four ounces of milk, then tie over the cup a 
piece of linen, place the cup in a shallow sauce- 
pan half full of water, and boil ten minutes. 

Soft-boiled Place a fresh egg in enough boiling water 
to cover it, move it to the back of the stove 
and let it stand five minutes where the water 
will keep hot, but not boil. Serve with a 
pinch of salt. An egg to be properly cooked 



BUTTERMILK — MALT SOUP 85 

should never be boiled in boiling water, as 
the white hardens before the yolk is cooked. 
The yolk and white should be of a jelly-like 
consistency. 

Place a slice of bread in the oven, and dry Toast, 
until crisp but not brown. Place it on a toast 
fork and hold it over the flame of a coal fire 
for a few seconds until brown on both sides. 
Butter while hot. 

This meat pulp is prepared by scraping Raw 
with a dull knife a piece of raw or underdone steak 6 
round steak. Add salt to taste. The raw 
yolk of egg may also be added to the meat. 

Tie several pounds of wheat flour in a Baked 
cheese-cloth bag and boil in a pot of water for (F?our 
five hours. Remove from water and place 
in oven, and bake until quite brown on the 
outside. It will require from two to three 
hours slow baking. Break open and throw 
away the brown shell; the remainder, the 
baked flour, must then be grated into a 
powder. 

Boil one quart of milk, and when cool, skim Butter 

x ' ' milk. 

off the skin that rises. Add one teaspoonfuL ,. 

* Lactic 

of the pure culture of the lactic acid bacillus, ^j£ 
or one lactic acid tablet containing the bacillus 
(can be bought in any drug store). Set this 
inoculated milk in a warm place (temperature 



86 THE HEALTH-CARE OF THE BABY 

about ioo° F.) for twenty-four to thirty-six 
hours. The lumpy mixture must then be 
thoroughly shaken, and if of a thick creamy 
consistency, must be placed in a cool place to 
retard further souring. 

Mait Dissolve $/2 ounces of malt soup 1 in i pint 

of warm water. Then mix 3 ounces (in 
measure) or 2 ounces (in weight) of wheat 
flour in 1 pint of milk. When the wheat flour 
and milk solution is strained it is added to the 
malt soup extract solution and slowly brought 
to a boil, being stirred constantly over a slow 
fire. Bring to a boil three times. Cool it off 
quickly by standing it in cold water. 

steamed All cereals served to children must be 
steamed at least two hours in slightly salted 
water. Serve with butter and sugar or with 
cream and sugar. 

1 Sold in drug store under name of Loef3und's malt soup. 



PART III 

Miscellaneous Diseases and Emergencies 



CHAPTER I 

VOMITING AND COLIC 

\EERE are so many causes for vomiting From 
in infants and children that whatever it PeSmg! r 
be, the cause should be carefully studied. 
Vomiting may be the result of over feeding, or 
due to infants gulping their food or drinking 
it too hastily. When the vomiting that is due 
to improper feeding continues, absolute rest 
of the stomach is demanded. In such cases 
from an interval of two hours there should be 
a change so that we feed once in three or even 
four hours. In many cases of vomiting the 
food is too rich in fat (cream); hence more 
water should be added. When vomiting fol- 
lows breast feeding, the baby should receive 
several teaspoonfuls of rice or barley water 
before each breast feeding to dilute the breast 
milk. 

Vomiting may be caused by disease; hence 
repeated vomiting with or without fever means 
something more than a trivial stomach com- 
plaint. For example: If a child falls down 
8 9 



90 THE HEALTH-CARE OF THE BABY 

a flight of stairs and continues to vomit, such 
vomiting is due to concussion of the brain. 
If a child is developing scarlet fever the first 
symptom usually noted will be repeated at- 
tacks of vomiting. Brain fever (meningitis) 
frequently begins with vomiting. No amount 
of changing of the food formula will relieve 
such attacks. 

When vomiting occurs, give a dose of castor- 
oil, or a rhubarb and soda tablet, dissolved in 
a little water, repeat this dose in two hours if 
vomiting continues. Dilute the food by using 
one-half the quantity of milk previously given 
and add an equal part of water. If vomiting 
still persists after these measures have been 
taken, consult the physician at once. 
Colic. Colic, as it frequently occurs in young in- 

fants, is usually caused by indigestion. It 
occurs most frequently in bottle-fed infants. 
When it occurs frequently in a breast-fed in- 
fant, give an ounce of hot water just before 
nursing. The mother should see that her 
bowels move freely each day; she should take 
plenty of exercise and a light, nourishing diet. 
When colic exists baby will draw up his 
legs on the abdomen and cry and scream. I 
have already in the article on "Cry, "■called 
attention to the peculiar, sharp cry denoting 



CONVULSIONS 91 

pain. The abdomen is usually distended 
and if the ear is placed over the abdomen a 
distinct rumbling noise can be heard. No 
amount of rocking or soothing will comfort 
the baby until the colic is relieved. A hot- 
water bag, or a warm flaxseed poultice, should 
be applied to the abdomen. Rubbing the 
abdomen with warm sweet-oil, as described 
in the article on massage, will usually relieve 
the pain. One drop of essencfe of peppermint 
to a teaspoonful of warm water may be given 
every fifteen minutes until baby is soothed. 
Injections of warm soap water into the bowel 
will instantly relieve the colic. When colic 
recurs the food requires modification. As a 
rule we must add less milk and increase the 
diluent, be it rice or barley water. 

Hiccup is due to a spasm of the dia- Hiccup, 
phragm. A tight-fitting abdominal bandage 
will frequently check this spasm. One drop 
of Hoffman's anodyne may be given every 
hour to a baby one year old, and every half- 
hour to an older child. 

If the baby overloads his stomach, or ifqonvui. 
improper food has been given and stagnates slon! 
in the intestine, general poisoning may result, 
with fever and convulsions. When convul- 
sions appear the muscles of the arms and 



92 THE HEALTH-CARE OF THE BABY 

legs are usually stiffened, the facial muscles 
are distorted, the eyes roll upwards, the jaws 
are firm, the teeth locked, and frothing of the 
mouth may take place. When convulsions 
occur the physician should be summoned; 
until then, the following general rules should 
be followed: 
Mustard An ice-cold cloth or an ice-bag may be laid 
'on the head. A foot-bath should be given in 
tepid water at a temperature of 90 F., to which 
one or two tablespoonfuls of powdered mus- 
tard should be added. The feet should be 
bathed until the skin is reddened or until the 
muscular rigidity ceases. The bath should 
not be prolonged more than three minutes. 
If the spasm continues after the mustard foot- 
bath has been given, then a pint of soap- 
water should be injected into the bowels as 
an enema. This will cause a movement of 
the bowels. 




CORRECT POSITION OF A BABY WHEN GIVING AN INJECTION TO AID 
THE MOVEMENT OF THE BOWELS 



CHAPTER II 
CONSTIPATION 

THE baby's bowels should move at least 
once in every twenty- four hours. If the 
action of the bowels is sluggish, he will not 
have a movement every day. This sluggish 
action can be caused by different conditions, 
but is most often due to faulty feeding. If in Breast. 

fed 

the baby is fed at the breast, the mother or wet- Babies 
nurse must see that her breast milk is kept in 
a healthy state. Her milk should be exam- 
ined by a physician or chemist to determine 
whether or no enough fat (cream) is present. 
If a deficiency of cream exists then we can give 
baby one or more teaspoonfuls of cream from 
cows' milk, in a little warm water immedi- 
ately before nursing. Several teaspoonfuls of 
water sweetened with granulated sugar and 
given before nursing will frequently relieve 
constipation. 

If the baby is bottle-fed and his digestion in Bottle- 
is good, then increase the quantity of cream Babies - 
or top milk by adding a teaspoonful or more 

93 



94 THE HEALTH-CARE OF THE BABY 

to each bottle. If milk has been subjected to 
prolonged heating, then stop using boiled 
milk and give pasteurized milk warmed 
to about ioo° F. or the usual feeding tempera- 
ture. A teaspoonful or more of Mellin's 
food added to each bottle will modify con- 
stipation for the time being. A teaspoon- 
ful or more of Loefflund's malt soup added to 
each bottle will also have a laxative effect. 

When constipation follows the use of Es- 
kay's food, it can be corrected by adding 5 
to 10 grains of phosphate of soda or calcined 
magnesia to the morning bottle. No more 
than one dose should be given in a day. If 
this does not correct the constipation, then no 
change of food should be made without medi- 
cal advice. 

Water. A drink of water between feedings will fre- 

quently help to relieve continued constipation. 

Fruits and The scraped pulp of a raw apple or the pulp 

juices. f a good mellow peach will aid in relieving 
constipation. Apple sauce or prune jelly may 
be given between meals. Orange juice, grape 
juice, pineapple juice or apple cider will be 
found beneficial. 

Massage. Kneading or stroking the abdomen over 
the bowels will stimulate the circulation if 
regularly performed. The fingers or hands 



CONSTIPATION 



95 



of the mother or nurse should be oiled and by 
means of gentle stroking begin in the following 
manner: Have your hands warmed as well 
as oiled, begin at the right groin and lightly 
rub the fingers in a circular motion upward, 
until the umbilicus is reached; then rub 
across the umbilicus and down the left side 




CORRECT METHOD OF GIVING MASSAGE TO RELIEVE 

CONSTIPATION. 

Note the Position of the Right Hand of the Nurse. 

to the groin. Begin again at the right groin 
and press a little deeper each time as the 
baby grows used to it. This should be done 
every morning and evening for from five to 



96 THE HEALTH-CARE OF THE BABY 

ten minutes and can be continued for several 
weeks. In obstinate cases several months of 
treatment may be necessary. 

Enema. The baby, as I have said, should not be 

allowed to go more than twenty-four hours 
without a movement. Immediate relief can 
be given by an injection into the bowel through 
the rectum of one-half pint of hike warm 
castile soap water, to which one tablespoon- 
ful of glycerin has been added. 

supposi- Sometimes a very little stimulant to the 

tones. ^ 

rectum is all that is needed. A suppository 
usually acts quickly. The best for the baby 
are those made of glycerin or gluten. They 
are small and conical in shape and resemble 
the old-fashioned "soap stick." One of these 
suppositories should be dipped into vaselin or 
olive-oil and gently inserted into the baby's 
rectum and held there until the movement 
pushes it out. These suppositories may be 
continued for several weeks. 

No mother or nurse should give the baby 
any drugs for his bowel movements without 
the supervision of a physician. They should 
try any or all the remedies here suggested be- 
fore giving the baby any drugs. Many cases 
of death by poisoning have occurred through 
the careless use of patent cathartics. 



Drugs. 



CHAPTER III 
MALNUTRITION (MARASMUS), RICKETS, ETC. 

WHEN the baby, who has been in good 
health while fed with human breast 
milk, is suddenly deprived of this good food, 
trouble usually begins. If too rich cows' 
milk, such as top milk or cream is tried, the 
baby will vomit and be colicky, the stool will 
contain curds and as a result there will be 
restlessness and crying day and night. The 
colic and the vomit denote that the food does 
not agree with the stomach. Such infants 
require an immediate change of food suited 
to their digestion. If this trouble is not 
rapidly corrected, they do not gain in weight 
but lose. When this condition persists for 
a month or two, the fatty cushions on the arms 
and legs disappear and the infant seems to 
shrivel up, pine and waste away. These in- 
fants resemble little skeletons and their skin 
hangs in loose folds. Such infants require 
fresh air and frequently owe their marasmus 
to being deprived of it in tenement-houses or 
small, ill- ventilated apartments. 
97 



98 THE HEALTH-CARE OF THE BABY 

The milk of a wet-nurse, 1 even though her 
milk is several months younger than the 
marasmic baby, will frequently work wonders ; 
goat's milk, properly modified, is frequently 
adapted to relieve this condition. The diffi- 
culty in prescribing proper food for a maras- 
mic child should be thoughtfully considered 
by the mother or nurse before resorting to 
experimental feeding. The physician should 
be called and a definite plan of treatment fol- 
lowed. We must not expect to see immedi- 
ate changes, although improvement should be 
noted within four weeks. As the life of the 
child is at stake, no conscientious mother or 
nurse will risk experimenting with the food, as 
such attempt may prove fatal. Cod-liver oil 
and malt may do good, but even these remedies 
should not be given without medical opinion. 
Rickets. Rickets is a disease caused by improper 
feeding and improper ventilation. The bones, 
instead of being hard and firm, are soft and 
spongy, and sometimes very thin. The mus- 
cles, instead of being hard and firm, are soft 
and flabby. There is a general backwardness 
of development. Rickety children are back- 
ward in teething, and when the teeth do ap- 
pear, decay very rapidly. They are back- 
ward in walking and backward in talking 
1 See page 60, 



RICKETS 99 

and the soft- spot (fontanel) on the top of the 
head remains open months longer than it 
should. Owing to the soft bones which yield 
on walking the child becomes bow-legged. 
The ends of the bones are enlarged, and the 
ribs are beaded. 

These children usually suffer from con- 
stipation and have a distended abdomen. 
They are restless at night and peevish by day. 
They perspire freely, especially while feed- 
ing. The back of the head is usually bald 
from rubbing the head back and forth on the 
pillow. If a breast-fed baby shows signs of 
rickets the breast milk must be examined at 
once by a chemist in order to determine the 
quantity of fat, sugar and proteids that it 
contains. When nursing is prolonged and 
the mother menstruates regularly, rickets may 
develop. As a rule babies fed on condensed 
milk or those receiving insufficient fat or 
cream develop rickets. When the baby is 
kept indoors and over-bundled with clothing, 
he soon loses his appetite and if this con- 
tinues for weeks and months he will become 
under-nourished, and as a result rickets in some 
form will be shown. Fresh cows' milk simply 
warmed, not boiled, should be given. Fruit 
juices, such as orange, lemon, pineapple and 



IOO THE HEALTH-CARE OF THE BABY 

grape juice and raw- scraped apple pulp should 
be given. Butter, yolk of raw egg, with 
sugar, cereals, and the dairy products, such 
as cream cheese should form the bulk of the 
diet. When severe constipation is encoun- 
tered, honey and several teaspoonfuls of sweet 
oil may be given daily. Cod-liver oil, maltin 
or morrholin should be given in doses of one 
teaspoonful three times a day. Rickety chil- 
dren require fresh air; they should sleep in 
well-ventilated rooms. While out of doors, 
they should be placed in the sun. A sun bath 
is very important. The daily morning bath 
should be of lukewarm water to which one 
pound of sea salt is added. After the bath 
the child should be briskly rubbed with a 
coarse turkish towel. No case of rickets 
should be neglected, or the deformities will 
remain throughout life. 
Seurvy. A child that has been improperly fed will 

frequently show evidences of such bad feed- 
ing by having a weakened framework. The 
bones will be spongy and the muscles flabby. 
The joints will swell and resemble rheuma- 
tism. The child will be covered with bluish- 
black spots as though it were bruised. New 
spots will appear when the child is roughly 
handled. The gums, with a deep purple 



JAUNDICE IOI 

color, are swollen and look spongy. They 
frequently bleed. Nosebleed or blood in the 
urine and stools accompanies this condition. 
The child appears pale and has no appetite. 

If the child has been fed with a patent food 
its food must be changed at once. Raw milk 
must be given and all forms of steaming and 
sterilizing must be stopped. Orange juice, 
grape juice and raw steak juice must be added 
to the diet. This is generally all the treatment 
necessary. 

In jaundice there is an intense yellowish Jaundice, 
color to the skin. The whites of the eyes ap- 
pear yellowish. The urine instead of being 
yellow in color has a brownish color. The 
stools instead of being brown, are white or 
clay colored. The child may vomit and fever 
may be present. Headache will be com- 
plained of by older children. They are lan- 
guid and tired and will want to go to bed. 
When the new-born baby has jaundice the 
physician should at once be summoned. 
Jaundice may be caused by a liver distur- 
bance or by some poison in the blood. In 
older children jaundice is frequently asso- 
ciated with catarrh of the stomach, in which 
case it extends to the bile ducts. Under the 
care of a physician these cases recover. 



CHAPTER IV 
FEVER AND TEMPERATURE 

THE normal temperature of a baby ranges 
between 98 £ and 99 J° F. If the baby 
has a temperature of 99 to ioo° F he should 
not be considered feverish. A temperature 
of 101 to 102 F usually means a mild disease. 
A temperature of 103, 104 or 105 F means a 
severe febrile condition. Children are very 
sensitive and hence respond very quickly to 
conditions giving rise to fever. For instance, 
an overloaded stomach or a stagnant bit of fer- 
menting milk- curd in the intestine will give 
rise to auto-intoxication resulting in fever as 
high as 105 F and frequently will cause con- 
vulsions. 
sudden If a child is well in the morning and sud- 

denly develops a temperature of 103, 104 or 
105 F, this usually implies a sudden dis- 
turbance of the stomach or bowels. As a rule 
sudden fever is not dangerous, but responds 
readily to treatment. 



FEVER AND TEMPERATURE I03 

When fever comes on gradually, and in- Fever De- 
creases J to 1 degree every day for a number siowiy. 
of days, it is usually a bad sign. This form 
of temperature is met with in typhoid fever. 

It is important to remember that fever is when 

,. . -n Fever is 

absent in many diseased conditions. For ex- Absent. 
ample, brain fever and even scarlet fever and 
pneumonia may sometimes be present and 
still the temperature of the body be normal 
during the whole course of the disease. 
A teaspoonful of castor-oil is always a safe what to 

r J do for 

remedy no matter what brought on the fever. Fever. 
A teaspoonful of aromatic sirup of rhubarb 
may be given once only. One of the most 
rapid methods of reducing fever is by wash- 
ing out the bowel, with a pint of soap water, 
by means of a fountain or bag syringe. If the 
mother or nurse is skillful the injection may 
be given high up in the bowel, by introducing 
a catheter two or three inches into the rectum 
and following it up into the colon three inches 
more. Fifteen drops of sweet spirits of niter 
in a teaspoonful of water may be given. This 
may be repeated every hour until three or 
four doses have been given. As niter acts on 
the kidneys it eliminates fever and poisonous 
products through the kidneys by increasing 
the flow of urine. 



104 THE HEALTH-CARE OF THE BABY 

Sponging If fever persists then a sponge bath, con- 

. the Body. . . . r p , i i t /- 

sistmg of one part of alcohol and five parts 
of cold water, should be given. The body 
should be sponged every half-hour until the 
physician arrives. 
Rash. If an eruption is found on the body, a phy- 

sician should be consulted before any spong- 
ing or cooling is begun. 
Feeding If the child is still on a milk diet, we should 
Fev^. give a weaker food by taking away half the 
quantity of milk and adding the same amount 
of water. In some fevers even weak milk will 
not be tolerated and nothing but whey or thin 
soups will be tolerated. 

Older children who have been on a diet of 
solid food should receive only liquids during 
the fever. Plenty of water should be given. 



CHAPTER V 

GENERAL RULES FOR CONTAGIOUS! DISEASES 
AND FEVERS— ISOLATION 

PUT the child to bed. 
Give a teaspoonful of castor-oil or aro- 
matic sirup of rhubarb. 

One hour later give an infant 15 drops of 
sweet spirits of niter, and an older child 30 
drops. 

If twitching of the muscles is noticed and 
the child has had convulsions before, then 
give a strong mustard foot-bath for two or 
three minutes. 

If twitching continues one-half hour after 
the foot-bath, then give an injection into the 
rectum of one pint of soap water. 

For thirst give one or several tablespoon- 
fuls of citrate of magnesia. 

Do not give pure milk in fever but dilute 
the food one-half. Thin soups, lemonade 
and orangeade may also be given. 

Do not bathe the child if an eruption is 
seen on the skin unless the physician especi- 
ally orders it. 

i°5 



106 THE HEALTH-CARE OF THE BABY 

Wrap the patient in a blanket and take 
him out of the sick-room into an adjoining 
room twice a day to permit thorough ventila- 
tion of the sick-room. 

The spread The spread of most diseases is caused 
" through ignorance or carelessness. So-called 
colds, such as running nose, sore throat and 
bronchitis are easily communicated to children 
and may be serious for the baby. Do not 
sneeze or cough in the baby 's face. A mother 
or nurse should protect the baby from catch- 
ing her own cold by tying a handkerchief or 
piece of cheese cloth over her nose and mouth 
when nursing or caring for the baby. She 
should not kiss the baby, neither should she 
use her own handkerchief for the baby. The 
baby should never be taken to the room of a 
sick person, until the true nature of the illness 
is known. If the disease is contagious, the 
separation must be kept up. The patient must 

isolation, be isolated. This isolation consists in placing 
the patient in a room by himself, and giving 
him separate dishes, washcloths, towels, etc. 
Only one person should care for him, and the 
clothing of this person should be protected by 
a long gown when in the patient's room. 
After handling the patient the hands must be 
carefully washed in warm water and soap. 



CHAPTER VI 

MEASLES, SCARLET FEVER, DIPHTHERIA, 
CROUP AND TUBERCULOSIS 

IN measles the first thing usually noticed by Measles. 
the mother is that the baby appears to 
have taken cold. He will sneeze, have a 
catarrh in the head and cough. The eyes 
are dull, the appetite poor and there is usually 
fever. Three or four days later a rose-colored 
rash will appear on the face and neck, and 
later spread to the chest, arms and legs. 

At the first symptoms the baby should be 
put to bed in a darkened room, or with his 
back to the light on account of the inflamma- 
tion of the eyes. Plenty of fresh air should 
be allowed to enter, and the temperature of 
the room kept at about 70 F. All other 
children should be kept from the room or 
house if possible, as nine out of every ten, if 
exposed, will take this disease. If children 
remain well fourteen days after exposure, then 
they will probably escape. As a rule the dis- 
ease appears between seven and fourteen days 
107 



108 THE HEALTH-CARE OF THE BABY 

after an exposure. Bathing should be stopped. 
No child should be permitted out of bed, no 
matter how good he feels until the rash has 
entirely disappeared. This may in some cases 
require a child to be in bed five to seven days. 
Complications can be avoided by this pre- 
caution. It is the careless mother or nurse 
who, disregarding a mild bronchitis, will ex- 
pose a sick child in order to harden it and 
later be rewarded by finding that the child 
has contracted a fatal pneumonia. Con- 
tinued fever after the measles' rash has dis- 
appeared means the development of some 
complication. 
German This disease resembles ordinary measles, 

Measles. < . . 

although it is a much milder disease and does 
not begin with sneezing and coughing. Some- 
times there is a slight fever, but more often 
the first symptom noticed is the rash. The 
pale red rash usually appears all over the 
body. It varies in size from a pin-head to a 
small pea. It disappears in three or four 
days. The child should be kept in bed and 
put on a light diet. This is all the treatment 
necessary. The patient should be isolated, 
It a child has been exposed to this disease he 
will usually show signs of it at any time from 
the fourth to the twentieth day after exposure. 



MEASLES, SCARLET FEVER, ETC. 109 

The early symptoms of scarlet fever arescariet 

Fever. 

sore throat, headache, high fever, and vomit- 
ing which may occur in spite of a most careful 
diet. Convulsions sometimes occur. From 
twenty-four to thirty-six hours after the first 
symptoms are noticed a rash of a deep red or 
bluish-red color usually appears, first on the 
neck and chest, and later covering the body. 
This rash is very fine and the parts of it ap- 
pear so close that the whole body has a very 
red appearance. This rash usually remains 
five or six days and then begins to peel off or 
desquamate; this usually takes from two to 
four weeks. The strictest isolation must be 
observed. 

A child after being exposed to a case of 
scarlet fever may show the first symptoms 
any time within twelve days. The treat- 
ment must be left to the physician. 

Chicken-pox is a contagious disease. If the chicken- 
baby has been exposed he will probably have P ° 2 
an eruption between the fourth and fourteenth 
days after exposure. Usually the first symp- 
tom noticed is a slight fever and a series of 
pimples scattered over the body. These pim- 
ples are at first small, and gradually grow 
larger and resemble water blisters. In a few 
days they dry up and the crust falls off. The 



theria. 



IIO THE HEALTH-CARE OF THE BABY 

eruption does not all appear at one time, for 
while new pimples are forming, others are 
drying up. This disease is frequently found 
in very young infants, especially if they have 
not been vaccinated. There is no danger in 
this disease if the child is kept in bed, the 
bowels cleansed, and no solid food is given. 
It may be communicated to healthy children 
as late as sixteen days after the first symp- 
toms appear. 
Diph- Usually the first symptoms of diphtheria are 

loss of appetite, swelling of the glands at the 
angle of the jaw and grayish white or yellow- 
ish patches in the throat. As soon as the 
mother sees patches in her baby's throat she 
should notify her physician at once. If they 
are true diphtheritic patches prompt treat- 
ment must be given if the baby's life is to be 
saved. Until the physician arrives, one or 
two glasses of citrate of magnesia may be 
given to cleanse the bowels. No solid food 
should be given, only milk, gruels and broths. 
For thirst, ice-cream and water ices should be 
taken. For very young infants dilute the 
food one-half with water. The patient must 
be strictly isolated. If other children are ex- 
posed, they are likely to get the disease any 
time within one week after exposure. 




CORRECT METHOD OF HOLDING A BABY FOR THE EXAMINATION OF 
ITS MOUTH AND THROAT 



DIPHTHERIA AND CROUP III 

There are two kinds of croup, catarrhal or Poise 

Croup. 

false croup and diphtheritic or true croup. 
Catarrhal or false croup is the kind that comes 
on suddenly in the night in an apparently- 
healthy child. It is the result of a simple 
filling up with mucus. The baby may have 
had a cold or been exposed, but more often 
no special cause can be found for this sudden 
attack. The baby may wake up during the 
night with a hoarse barking or crowing cough, 
and seem to breathe with difficulty. 

One of the best methods of relieving this 
cough is to have a croup kettle or a teakettle 
with a long spout so placed that steam coming 
from the kettle will be inhaled by the baby. 
Ten or fifteen drops of spirits of turpentine 
may be added to the steaming water. This 
steam should be kept up for several hours so 
that the air in the room becomes saturated. 
If the attack is very severe a teaspoonful of 
sirup of ipecac may be given. If vomiting 
does not result then give another dose of 
ipecac in twenty minutes. This form of croup 
comes on suddenly and disappears suddenly 
if the emetic is given. There is no danger 
to a child's life even though such an attack 
comes on after exposure to cold. 

A croupous cough that is accompanied by 



112 THE HEALTH-CARE OF THE BABY 

True fever and comes on very slowly is usually of 

Croup. . »■/ t« i 

a serious nature. If white patches or spots 
can be seen in the throat then the sooner the 
physician is consulted the better for the child. 
Tubercu- ] Tuberculosis often gets its start in infancy. 
Every effort should be made to protect the 
baby from infection. Common ways of in- 
fecting the baby are by kissing it, coughing 
or sneezing near the child, or by allowing it to 
sit on the floor where it has a good chance to 
pick up tuberculosis germs with the dust on its 
toys or other objects and thus get them into 
its mouth. Baby should have a separate room 
or at least part of a room fenced off for his 
play room, and the floor covered with a clean 
sheet every day. Milk from tuberculous cows 
may also be the cause of tuberculosis in the 
baby. 



CHAPTER VII 

WHOOPING-COUGH AND TONSILLITIS 

*HE first symptoms of whooping-cough whooping* 
are those of an ordinary cold with a 
cough. This lasts about ten days, when the 
cough gets stronger until a pronounced spasm 
appears. These spasms consist of a number 
of short, quick coughs, then a long-drawn 
inspiration known as "the whoop." During 
these coughing spasms the baby will get very- 
red, sometimes bluish-red in the face, and 
frequently the spasm ends with a vomit- It 
will be noticed that the cough is worse indoors 
and is least troublesome out-of-doors. The 
spasms are strongest at night. This is usually 
so because the windows are tightly shut. 
Fresh air night and day are very necessary for 
a cure. 

The danger in whooping-cough consists of 
exhaustion following lack of food as a result 
of the constant vomiting. If a breast-fed 
baby suffers with whooping-cough, the feed- 
ing should be more frequent and less in quan- 
tity. The same rule applies to a bottle-fed 
113 



114 THE HEALTH-CARE OF THE BABY 

baby. For example: If baby has been re- 
ceiving a bottle containing six ounces every 
three hours, he should, while the vomiting 
lasts, receive a bottle containing four ounces 
every two hours. If the swallowing of food 
provokes a coughing spasm and results in 
vomiting, then the food may be given, in some 
cases every hour. In this method baby will 
have a chance to obtain a little nourishment 
from his food before it is thrown off. Con- 
centrated food, such as yolk of egg, white of 
egg, and steak juice, made by expressing the 
juice from broiled steak, may be given. Older 
children may receive custard, junket, cereal 
puddings and raw-scraped steak mixed with 
the yolk of an egg. Cod-liver oil in teaspoon- 
ful doses given three or four times a day will 
nourish the body. Medication does not, as 
a rule, help in this disease. Whooping-cough 
runs its course in about twelve weeks; plenty 
of fresh air night and day, or a change of air 
to the seashore or mountains, tends to shorten 
the disease. Whooping-cough is one of the 
most contagious diseases and if a well child is 
exposed to it he is pretty sure to show symp- 
toms within three weeks after exposure. 
Cold in One of the most common disorders of child- 

the Head. 

hood is cold in the head. Sneezing, sniffling, 



TONSILLITIS AND ADENOIDS II 5 

and a running nose are the symptoms. If 
fever accompanies the cold, consult a physi- 
cian, as a running nose is frequently a symp- 
tom of adenoids and one of the earliest symp- 
toms of measles. Relief can be afforded by 
spraying the nose with warm water contain- 
ing a pinch of bicarbonate of soda, morning 
and evening. If the nostrils are plugged with 
mucus one or two drops of alboline or sweet 
oil should be dropped into the nostrils from 
a spoon or a medicine dropper. Older chil- 
dren can be allowed to sniff salt water into 
the nostrils. 

When a child refuses to eat and has fever Tonsils 
the throat should be examined. If the tonsils 
are inflamed they will be either reddened or 
coated with whitiali pin-point spots. The 
temperature may reach as high as 102-104 F. 
Until a physician can prescribe, citrate of 
magnesia may be given in wineglassful doses, 
as it will relieve the thirst and has a laxative 
effect. Cold cloths should be wrapped around 
the neck and small pieces of cracked ice or ice- 
cream may be given. 

This disease should be treated by a physi- 
cian to avoid having chronic enlarged tonsils 
V 7 hich may require removal later on. 

Adenoids consist of small masses of red- Adenoids. 



Il6 THE HEALTH-CARE OF THE BABY 

dened granulations resembling proud flesh. 
They occur in the back of the nose and on the 
pharynx. They can seldom be seen by look- 
ing into the throat, but can be felt by intro- 
ducing the finger into the throat. If the child 
snores at night, is restless and cannot sleep, 
if it cannot breathe through its nose and the 
mouth is used for breathing, then adenoids 
are very likely present. When catarrh recurs 
several times adenoids usually develop. Bed- 
wetting is frequently noted in children suffer- 
ing with adenoids. These children are peev- 
ish, sensitive and cry; they are very nervous 
and must be coaxed to eat. They gag and 
vomit easily. They are usually very thin and 
frail and backward in development. They 
have a foul breath. If adenoids are present 
they should be removed by the physician. 
Mumps. In mumps the glands situated under the 
angle of the jaw at the sides of the neck be- 
come swollen. Sometimes both sides are af- 
fected. There is a loss of appetite, pain on 
opening the mouth and sometimes a slight 
fever. This disease can spread; hence all 
children must be kept away from it. If a 
child has been exposed he may develop symp- 
toms as late as two or three weeks. These 
cases get well very easily if a liquid diet is 



DEAFNESS 117 

given, the bowels kept loose and the swollen 
parts protected with absorbent cotton and oil 
silk. 

Swollen glands may occur on the sides of the f^°^?* 
neck or below the jaw, under the arms or in 
the groins. These swellings may disappear of 
themselves, but when they remain for months 
we must suspect a constitutional disease, such 
as tuberculosis or scrofula to be the origin of 
the trouble. When glands swell on either side 
of the neck, the throat, especially the tonsils, 
require examination. Swollen glands in the 
neck may be caused by diphtheria in the 
nostrils or throat, or by an abscess forming in 
the middle ear. Lice will sometimes cause 
swelling of the glands around the neck and 
back of the head. Swollen glands will some- 
times appear in the armpits after vaccina- 
tion. 

A proper examination should be made by the 
physician to determine the cause of the gland- 
ular swellings. 

Deafness is frequently caused by adenoid Deafness, 
vegetations in the throat. Deafness in children 
can frequently be cured by the simple removal 
of such growth. Catarrh, affecting the nose 
and throat, frequently closes the Eustachean 
tubes, resulting in deafness. The treatment is 



Il8 THE HEALTH-CARE OE THE BABY 

simple but cannot be carried out by the aver- 
age mother or nurse. 
Growing When children complain of pain in their 
Rheuma- J * 11 * 8 ? such pain must not always be attrib- 
tism. ute( j j- growing — it may be rheumatism. 
Many cases of rheumatism with fatal heart 
disease have been traced back to supposed 
"growing pain." Very active exercise in- 
dulged in by children with feeble muscles and 
joints is frequently followed by pain mistaken 
for "growing pain." There is always a cause 
for joint pain, and if such pain continues it is 
better to consult a physician. 
sprue: The tender mouth of the new-born infant 

Mouth. can easily be infected with an unclean nipple 
or pacifier containing disease germs. This 
may result in an infection of the mouth called 
sprue. 

One-third of a teawSpoonful of borax and 
honey given three times a day, or several 
drops of glycerin^ dropped into the mouth 
after each feeding will relieve this condi- 
tion. 

Stagnant milk in the mouth, especially in 
a feverish child, can produce soreness and 
ulceration. A drink of water after each feed- 
ing is sufficient to cleanse the mouth and 
prevent the condition. In obstinate cases 



SPRUE: SORE MOUTH I19 

boric acid powder dusted into the mouth 
may be required. Attention to the bowels to 
avoid constipation is necessary in every case 
of sore mouth. 



CHAPTER VIII 

SKIN DISEASE 

Eczema. THfCZEMA usually occurs as an inflamma- 
« tory redness of the cheeks, arms and 
legs, especially between the thighs. It may 
occur at any age and is most frequently met 
with in the bottle-fed infant suffering with 
constipation and especially in babies suffer- 
ing with rickets. An excess of sugar is a 
frequent cause. It may also be the result of 
unsanitary measures such as permitting an 
infant to fall asleep and not change its soiled 
diaper. Fever does not accompany this con- 
dition. 

When eczema exists no soap should be used. 
The skin should be bathed in warm milk to 
which equal parts of bran water has been 
added. Bran water is made by adding one 
cupful of bran to one quart of hot water, al- 
lowed to soak for one-half hour, and then 
stirred occasionally and the liquid poured off. 
Oatmeal water may also be used to bathe the 
parts and will relieve the itching. After the 



SKIN DISEASE 121 

bath apply zinc salve. If the eczema does 

not disappear within a few days after the above 

treatment a physician should be consulted. 

In summer during extreme heat a finely Prickly 
, , , . . , , I,. Heat - 

mottled rash is sometimes found on the skin 

of children. This condition may also occur 
in winter if the child is too warmly dressed 
To relieve this, the flannels must be laid aside 
and only muslin or linen worn next to the 
skin. The body should be powdered with 
talcum or wheat flour after being washed with 
pure cold water. If itching accompanies this 
rash, a bran bath should be given. 

Very tight underclothing or very warm Chafing, 
clothing produce perspiration. If such per- 
spiration is very acid, it may cause irritation 
and by the friction of the clothing develop 
inflammation. When this continues the skin 
will appear highly inflamed and reddened, 
and at times develop crusts resembling eczema. 
When the buttocks or the genital tract is in- 
flamed and reddened we will notice that the 
child moves its legs or an attempt to scratch 
is made by rubbing the thighs. If this con- 
dition persists for a number of days then the 
skin between the thighs will develop crusts 
and we have an eczema. Neglect to change 
a wet diaper may cause chafing. If a baby 



122 THE HEALTH-CARE OF THE BABY 

is soiled from stool and not properly cleaned, 
chafing may occur. 

Do not use water to bathe the child. Clean 
the chafed parts with sweet oil and dust liber- 
ally with corn-starch. Zinc salve should cover 
the inflamed parts and if they do not im- 
prove within twenty-four hours consult a 
physician. 

chapped A tender skin when exposed to severe wind 

and Face, will sometimes crack and the skin appear 
very rough. This condition is very likely to 
occur if the skin is not properly dried before 
going out in the cold weather. At times a 
slight oozing of blood may take place. Apply 
melted cocoa-butter, cold-cream or zinc salve 
three or four times a day and stop bathing 
with water for at least one week. 

Sunburn. A highly inflamed and reddened skin fre- 
quently results from exposure to the sun's 
rays. Camphor ice, zinc salve or sweet cream 
from top milk applied several times a day will 
remove this inflammation. 

Hives. Round red blotches, sometimes as large as 

a twenty-five cent piece, having a whitish 
center resembling a mosquito bite, may ap- 
pear on the skin. They frequently follow a 
disordered stomach. These blotches come 
and go very quickly and require cooling with 



SKIN DISEASE 1 23 

baking-soda moistened with cold water and 
made into a paste. As a rule a dose of castor- 
oil or a teaspoonful of rhubarb and soda 
mixture for a baby one year old may be re- 
peated once every three hours until the bowels 
are thoroughly cleansed. For a baby six 
months old one-half the dose should be given. 
It is a good plan to stop all milk for at least 
six to eight hours, and give instead sweetened 
rice-water or plain water. In an older child 
stop eggs or meat one or two days and give 
buttermilk instead. Plenty of water should 
be permitted. 

Boils are abscesses of the skin and usually Boils, 
occur on the head and neck. They are most 
frequently due to local infections. When 
these boils occur on the scalp the hair should 
be trimmed around the boil and an incision 
will be necessary to empty the pus. All boils 
require careful antiseptic dressings which 
should be applied by a trained nurse or a 
physician. 

To remove the heat from a sting of an in- Mosquito 
sect or mosquito, the parts should be bathed 
with spirits of camphor or pure alcohol. If 
a child is forced to live in a locality where 
mosquitos abound, he should be screened both 
night and day. The germ of malaria can be 



worm. 



124 THE HEALTH-CARE OE THE BABY 

carried by a mosquito and an infant may be 
infected through its bite. Sprinkling the pil- 
low and bedclothing with a teaspoonful of 
alcohol to which ten drops of oil of sassafras 
has been added, has a tendency to keep mos- 
quitos away. 
Ring- A ringworm produces a round, red mark 

about the size of a twenty - five cent piece, 
sometimes larger. It is most frequently found 
on the forehead or scalp; it may, however, 
attack any part of the body. It is caused 
by a fungus which can be conveyed from 
person to person. If it appears on the scalp 
the hair should be cut short and the affected 
part painted with tincture of iodine. The 
cap, towel and everything coming in contact 
with the ringworm should be destroyed or it 
will convey the disease. 



CHAPTER IX 
ACCIDENTS AND EMERGENCIES 

IF the burn is mild and the skin but slightly Bums. 
broken, dust corn-starch or wheat flour 
over the burned area. Exclude air from the 
wound with a gauze bandage. If the burn is 
severe and blisters have been raised they 
should be opened with a new clean needle, 
and after the water has been emptied from the 
blisters, linseed oil and lime-water in equal 
parts should be applied by saturating steril- 
ized cheese-cloth or clean linen. No one 
should think of treating a severe burn without 
consulting a physician. 

If a splinter enters the flesh it should be Splinters 
removed with the aid of a clean, sharp needle 
and the part bathed thoroughly with witch- 
hazel. If a needle-point is imbedded and is 
difficult to dislodge a physician should be 
consulted. Frequently needle-points become 
so deeply lodged that an X-Ray examination 
must be made to locate them. 
125 



126 THE HEALTH-CARE OF THE BABY 

Bumps If a child falls and has a bump or a bruise, 

Bnuses. ice-cold cloths or cotton saturated with lead 
and opium wash should be applied. In the 
absence of lead and opium wash witch-hazel 
may be applied. 

cuts. If the skin is lacerated or torn and bleeds 

freely the wound should be washed with a 
one per cent, carbolic solution or with a 
1-2000 bichloride solution. It is necessary 
to wash the wound at least twice a day and 
apply a piece of iodoform gauze and a band- 
age over the wound. No one should dress a 
wound without thoroughly scrubbing his 
finger nails and hands. By introducing dirt 
from fingers or nails blood-poisoning can re- 
sult. 

If blood spurts from the wound, an artery 
has been cut and we should tie a handkerchief 
or a stout piece of muslin over the wound until 
a physician can be summoned. 

If the cut is very slight it may be washed in 
clean boiled water and tied with a clean piece 
of linen. 

Foreign if an infant has swallowed a whistle, a but- 

Bodies ' 

Throat ton or s i m ilar foreign body, give him a thick- 
stomach. ene d pap or bread soaked in milk until the 
physician can be called. If any difficulty 
with breathing is noticed give a teaspoonful 



EMERGENCIES 12 7 

of sirup of ipecac to produce vomiting. By 
this means we can frequently remove the for- 
eign body. Never give a cathartic. Holding 
baby head down, and slapping him firmly on 
the back will sometimes remove a foreign 
body from the throat. 

Hold the lids apart and with the aid of a in the Eye. 
small piece of linen, try to remove the foreign 
substance. An eyestone or flaxseed placed 
in the corner of the eye will sometimes remove 
the foreign substance. If the foreign body 
is not easily dislodged, do not tamper with the 
eye but call in a physician. 

If a very young infant has a foreign body ij* the 
in the nose, tickle the nostril by inserting a 
soft, dry feather. This will make him sneeze. 
In an older child the free nostril may be held 
shut and the child instructed to blow through 
the obstructed nostril. 

No one but a physician or a trained nurse 
should attempt to syringe a nose, as there is 
danger of the liquid flowing through the nos- 
tril into the middle ear and causing an abscess. 

An insect can usually be dislodged from in the Ear. 
the ear by pouringbne or more drops of sweet 
oil into the ear. A bead or similar substance 
can be removed by syringing the ear with 
lukewarm water. Do not use any hairpins or 



128 THE HEALTH-CARE OF THE BABY 

button-hooks to dislodge foreign bodies. As 
a rule, more harm can be done by meddling 
with a deep-seated substance than by leaving 
the ear alone until a physician can be con- 
sulted. 
Poisoning. The general treatment for poisoning is to 
rid the stomach as quickly as possible of the 
poison taken. This is done by emetics, such 
as a teaspoonful of mustard or alum in a 
glass of luke-warm water, or luke-warm salt- 
water, or a teaspoonful of ipecac, and then 
warm water, repeated every five minutes until 
vomiting has been produced. Then one or 
two teaspoonfuls of castor-oil should be 
given. If an acid such as carbolic or oxalic 
has been swallowed, then olive-oil should be 
forced down the child's throat. Bicarbonate 
of soda and water may be given if any acid 
has been swallowed. Warm or cold milk 
may be given as an antidote to any poison, 
until the physician arrives and uses the stom- 
ach-pump to empty the stomach of its poison- 
ous contents. If an overdose of soothing 
syrup or too much paregoric has been given, 
keep the baby awake by almost any means, 
such as slapping with a towel wet in cold 
water, or if the child is old enough walk him 
constantly up and down, or give a mustard 



EMERGENCIES 1 29 

foot bath, until a doctor can get there. Give 
several drops of whisky in water, and repeat 
every ten minutes. If the stupor persists 
combine whisky with hot coffee. 

When bleeding comes from any part of the Bleeding. 
body apply styptic cotton to the bleeding sur- 
face and bandage tightly. Powdered alum 
sprinkled on absorbent cotton is also useful 
to stop bleeding. 

If the finger is cut or scratched and bleeds, 
wash it in clean cold water and bandage 
tightly with a clean bandage. 

Nosebleed can be stopped by inserting 
into the bleeding nostril a small piece of ab- 
sorbent cotton soaked in tincture of iron. 
Small pieces of ice held against the nose will 
frequently stop the bleeding. 

In case baby is bitten by a pet cat or dog, cat or 
or, as sometimes happens, by a playmate, the ° 8 
parts should be washed with clean water, 
then apply tincture of iodine directly on the 
wound. If the bite is more than skin deep 
send for the physician. 



CHAPTER X 

EAR AND EYE 

Earache. VV7THEN the baby has earache he will cry 
▼V and scream continuously. As a rule 
he will put his hand to the affected side of 
his head, or press his head deep into the pil- 
low. Babies suffering with earache invari- 
ably rub their gums so that they sometimes 
convey the impression that they are teething. 
In some instances the head will be thrown 
back and the baby will appear to have a spasm 
of the muscles of the neck. When the affected 
ear is touched, baby will usually jump and 
scream with pain. 

A small hot-water bag should be covered 
and placed on the pillow and the baby al- 
lowed to rest his head on it. If this does 
not help the ear should be syringed with warm 
chamomile tea or with a teacupful of warm 
water containing one-half teaspoonf ul of bi- 
carbonate of soda. A small bag containing 
salt may be warmed and applied for its dry 
warmth behind the ear. Do not stick hair- 
130 



EAR AND EYE 131 

pins or other substances into the middle ear 
but rather consult a physician if the symp- 
toms do not subside after these remedies have 
been tried. 

A running ear that follows influenza, meas- Running 
les or scarlet fever requires careful antiseptic 
treatment. There is always a possibility of 
a running ear extending through ,into the 
deeper portions known as the mastoid cells. 

For a simple running ear, the ear may be 
washed with a teacupful of warm water con- 
taining one teaspoonful of bicarbonate of 
soda. This should be slowly injected into 
the ear by means of a small glass ear syringe. 
Powdered alum or boric acid, one-half tea- 
spoonful to a half pint of warm water, tem- 
perature 105 F., may be syringed into the 
ear night and morning. 

Projecting ears can be corrected by having Projecting 
the baby wear a thin but tight-fitting cap every 
night and during the day while asleep. The 
younger baby is, the easier this trouble will be 
corrected. At any age it will take months of 
constant treatment. 

If baby wakes up in the morning with a crusted 
cold in the head we may find pus oozing from / e3 
the eyes, and also find that the lids are glued 
together by this pus drying and forming 



I32 THE HEALTH-CARE OF THE BABY 

crusts. These crusts can be softened and 
loosened from the eyelashes by soaking them 
in boric acid solution (a pinch of boric acid 
to a wineglassful of lukewarm water) ap- 
plied on absorbent cotton. The lids should 
be bathed with this solution several times a 
day and after each bathing borated vaseline 
on cotton thoroughly applied. 
" sore t Many babies within two or three days after 

birth, sometimes later, have what is com- 
monly called "sore eyes." The eyelids be- 
come reddened and swollen, and later pus 
will be seen in the eyes. The child looks as 
though it had "caught cold in the eyes." 
The proper name for this condition is oph- 
thalmia. It is caused by a germ getting 
into the baby's eyes during birth. The phy- 
sician's attention should be called to this at 
once. Neglect and carelessness may result 
in blindness. 



CHAPTER XI 
BAD HABITS, ETC. 

THE habit of thumb-sucking is usually Thumb- 
formed at or about the period of den- 
tition. An irritant gum will seem to be re- 
lieved by the pressure of the finger. This 
habit may continue long after the child is 
through teething. It is met with more 
frequently than any other habit in early 
childhood, and frequently results in thick- 
ened and protruding lips. The upper jaw is 
sometimes forced out of shape by the pressure 
of the thumb back of the teeth. This re- 
peated day after day spoils the shape of a 
pretty mouth, and frequently the thumb 
and lips are blistered from the vigor of the 
sucking. 

The habit once formed is hard to break. 
Very few cases will of their own accord stop 
the habit. Reasoning, pleading and punish- 
ment are of little avail. If the child is 
shamed, it will seek seclusion and indulge 
in the habit at night, thus slyness and deceit 
will develop. 

i33 



134 THE HEALTH-CARE OF THE BABY 

Thumb-sucking frequently leads to nail 
biting. It is far more easy to prevent the 
habit, than to cure it once it is formed. As 
often as the thumb is put in the mouth, it 
should be gently but firmly removed, never 
should it be left there long enough for the 
habit to be formed. The application of 
tincture of aloes or a two per cent, quinine 
solution to the fingers will in many instances 
break up his habit, owing to the bitter taste. 
These solutions should not be applied as a 
punishment. The co-operation of the child 
should be sought, and by perseverance its 
self-will strengthened. 

If the habit has been indulged in for months, 
mechanical restraint may be necessary. The 
Hand-I-Hold mitts, procurable at any drug 
store, are convenient. They are easily ap- 
plied and do not limit the freedom of the arms. 
N>ii Nail biting is usually found in nervous 

children and is especially noticed when these 
children are frightened. Correction by rea- 
soning, scolding or spanking is seldom effec- 
tual. Place gloves on the child's hands con- 
stantly day and night as a reminder. If the 
habit continues in spite of the gloves, apply 
tincture of aloes to the nails and finger-tips 
night and morning. 



BAD HABITS 135 

When children over three years of age wet Bed 
the bed at night a distinct reason for the same 
exists. In a boy a tight foreskin may cause 
irritation and require circumcision. In girls 
worms wandering from the rectum into the 
vagina may irritate the opening of the bladder. 
At times the urine is at fault and must be cor- 
rected by proper diet. Meat should be 
stopped. Milk, eggs and fruit may be given. 
The' foot of the bed should be elevated and 
the bladder emptied the last thing before re- 
tiring. Electricity may be necessary to restore 
the tone if weak bladder muscles exist. Elec- 
tricity should only be given by a physician. 

By masturbation is meant playing with or Mastur- 
fumbling the genital organs. This is usually 
done with the hand or by rubbing the thighs 
together. When very young infants mastur- 
bate they rub their thighs together continu- 
ously until exhausted. They become very 
red in the face, and when restrained become 
very irritable. When older children mastur- 
bate they become very pale and anemic, 
they are absent-minded and shy, they fre- 
quently complain of headaches and have very 
irritable attacks. This is not always a bad 
habit but frequently is caused by some ab- 
normality of the genital parts. In such cases 



136 THE HEALTH-CARE OF THE BABY 

nothing but surgical relief will effect a cure. 
It may be caused by an irritation due to an 
elongated or [firmly adherent foreskin, or in 
girls when the skin over the clitoris is adher- 
ent. It may also be caused by the presence 
of worms or if the genital parts are not kept 
clean. Moral training is useless if any irri- 
tation exists which excites this desire, therefore 
as soon as this habit is noted the child should 
receive prompt medical aid. All children 
should be constantly watched to see if this 
habit is forming and they should never be 
permitted to sleep with their hands under the 
bed clothing. 

In older children the habit is hard to detect. 
A consciousness that they are doing some- 
thing wrong early leads even young children 
to get by themselves when they repeat the 
habit. One of the surest ways of detecting 
this habit is to examine the fingers of the 
child after it has fallen asleep. The odor of 
the genital organs is strong and can easily 
be detected on the fingers. 
Tight If the foreskin is tight and has a pin-point 

Foreskin. . - ° f 

opemng it may cause a series of symptoms, 
among them bed wetting, irritability and in- 
somnia. Such children usually fumble with 
the parts as there is constant irritation. 



BAD HABITS 137 

In some cases we can widen the foreskin 
with a dilator. This should only be at- 
tempted by a physician. With proper oiling 
every day relief is frequently given. If this 
stretching does not give permanent relief from 
the sleeplessness and the irritability then we 
must resort to circumcision. 

The operation of circumcision is verycircum- 
simple. Many cases of nervousness, such as° SI n 
St. Vitus dance, can be cured by this opera- 
tion. When adhesions of the foreskin form 
and there is a contracted prepuce, then cir- 
cumcision will be demanded. 



CHAPTER XII 

WORMS— NIGHT TERRORS 

Worms. A FTER the first year when children re- 
**> ceive some solid food in addition to their 
milk diet they may be troubled with worms. 
The majority of children seen by me, whose 
mothers suspect worms, rarely, if ever, have 
worms. Thread-like worms resembling spool 
cotton can be plainly seen when examining 
the rectum. As a rule there is an intense 
itching which compels the child to scratch. 
Restlessness at night and loss of appetite are 
rarely due to worms. It is true that an oc- 
casional case may be troubled with worms, 
but let a physician see the child and let him 
administer the worm medicine rather than 
run the risk of giving powerful medicines 
which are not at all necessary. 

Round worms, five or six inches long and 
brown in color, have been seen by me in young 
children. About two cases out of one hun- 
dred in which worms were suspected have 
really proven to be worm cases. When tape- 
worm is present we usually have loss of flesh, 
138 



WORMS I39 

although the child will take a fair amount of 
nourishment. It is only these tapeworm 
cases, found in children between six and 
twelve years of age and requiring careful diet 
besides expulsive treatment, that need cause 
any concern. Severe bleeding from the bowel 
has been seen by me when an anxious mother 
gave a strong patent tapeworm medicine, 
thinking that the child had worms. 

Sometimes children will suddenly awaken Night 
from a sound sleep and shriek or scream; others 
will grasp any object within reach, and some- 
times imagine that animals are in the room. 
Too rigid discipline or fright may provoke 
bad dreams and give rise to distinct hysteria. 
Such attacks may be provoked by intestinal 
worms, dyspeptic or intestinal derangement. 
The irritation of an elongated prepuce or a 
tight foreskin may cause night terrors. Mas- 
turbation in the male or female child will cause 
bad dreams and distinct nervous symptoms. 

While many cases are due to intestinal 
colic and an overloaded stomach, there are 
cases caused by brain disease, especially 
those cases having bulging of the soft spot 
on the top of the scalp. Cases of water on 
the brain (hydrocephalus) frequently have 
night terrors. This is called hydrocephalic cry. 



CHAPTER XIII 

EXTERNAL APPLICATIONS, AND THE 
MEDICINE CHEST 

Flaxseed TNTO a pint of boiling water stir flaxseed, 
-*> also known as linseed, until it forms a paste 
just thick enough to flow from a spoon; add 
a tablespoonful of sweet oil or glycerin; spread 
it one-half inch thick between two layers of 
cheese-cloth; apply where directed and cover 
with a layer of cotton, warm flannel or oil silk. 
If the part to be poulticed is anointed with 
sweet oil or vaselin before the poultice is ap- 
plied, no blisters will be raised. 

bustard To make a mustard poultice take one tea- 
spoonful of mustard and six teaspoonfuls of 
wheat-flour, add two teaspoonfuls of sweet oil 
or glycerin and enough warm water to make 
it into a thick paste. Spread between two 
layers of cheese-cloth, and apply to the part 
directed, after anointing the same with vase- 
lin. This poultice can be left on only a few 
minutes and when removed the skin should 
140 



THE MEDICINE CHEST 141 

again be anointed with vaselin or dusted with 
corn-starch. 

To give a mustard foot-bath, tie one table- Mustard 
spoonful of German mustard into a cheese- bath. 
cloth bag. Let this soak for a few minutes in 
a foot tub containing two quarts of warm 
water, temperature 105 F. The feet should 
be immersed to above the ankles for about 
two minutes. On removing the feet, place 
them near a hot-water bottle or wrap them 
in a warmed towel. 

A turpentine stupe is made by adding one- Turpen- 
half teaspoonful of spirits of turpentine to 
one pint of boiling hot water and mixing 
thoroughly. Dip two thicknesses of flannel 
into this turpentine and water and wring out 
until it does not drip. Apply where directed 
and cover with a large piece of cotton or oil 
silk. 

A pneumonia jacket should be shaped like Pneu- 
baby's sleeveless shirt. A layer of cotton is Jacket, 
placed between a layer of cheese-cloth and 
one of oil silk. The edges are turned in and 
the three layers basted together. The shoul- 
der seams or straps may be sewed together 
or tied with tapes. The front is closed by 
means of tapes sewed on either side. The 
jacket is worn with the layer of cheese-cloth 



142 THE HEALTH-CARE OF THE BABY 

next to the skin. Two jackets should be 
made so as to have a change when one gets 
moist. 
Hot- A hot- water bottle should be half-filled with 

Water 

Bottle hot water, the air expelled by pressing the 
empty part of the bag together, and the top 
screwed on. The bag should then be held 
upside down to see if the water drips. Draw 
over the bottle a flannel cover or sew the bottle 
in a square of flannel. 

ice-Bag. An ice-bag should be half filled with crushed 
ice, the air expelled and the top screwed on. 
If an intense cold is desired a little common 
salt may be added to the crushed ice. A 
layer of moist cheese-cloth or cotton should 
be laid between the bag and the skin, other- 
wise the extreme cold is painful. If the weight 
of the bag is uncomfortable to the patient, 
especially if applied to the head, then the bag 
may be wrapped in cheese-cloth and pinned 
to the pillow, so suspended as to barely allow 
it to touch the head. The bag must be re- 
filled before all the ice has melted. 

cold Cold compresses are made of three or four 

thicknesses of linen wrung out of cold water 
and applied where directed. Two com- 
presses should be used, one of which is kept in 
the cold water while the other is on the patient. 



THE MEDICINE CHEST 



143 



To give a simple enema, ordinary suds are Enema. 

1 • 1 -i i 1 (To wash 

made with castile or glycerin soap and warm out the 

& J r Bowels.) 

water, temperature ioo° F. A fountain syringe 
should be used, to which an infant's size 
nozzle is attached. Fill the bag with the 
amount of suds ordered (usually one or two 
pints) and anoint the nozzle with vaselin. 
Open the spring clasp on the tube and allow 
the air and a few ounces of water to escape. 
Gently insert the nozzle into baby's rectum 
and allow the water to flow in a slow, steady 
stream, the bag being held about two feet 
over the baby's body. 
A chamomile injection is made and given chamo- 

mile 

m the same manner as a simple enema, only irrigation 
chamomile tea, temperature ioo°, made by 
steeping one tablespoonful of chamomile 
flowers in a quart of boiling water, is used 
instead of the soap suds. 

The baby should have his own ointments, The 

mi i 1 i Medicine 

fountain syringe, etc. These should be keptcioset. 
in the nursery away from disinfectants and 
poisonous drugs. A list of the articles should 
be pasted on the inside of the door of the 
medicine closet so that in an emergency 
anyone may know whether a certain looked- 
for article can be found therein. 
Whether or not the closet contains poisons 



144 THE HEALTH-CARE OF THE' BABY 



such as paregoric, the door should always be 
kept locked, for an overdose of many drugs, 
whether poisonous or not, should be avoided. 

The key should be kept out of the children's 
reach, in a safe but accessible place known to 
all the adults. 

When the baby travels or when going to 
the country, a full and fresh supply of all 
drugs and requisites he is likely to need 
should be taken along. The following list 
should be supplied and will meet almost all 
emergencies: 

Castor-oil 

Glycerin suppositories 
Aromatic sirup of rhubarb 
Calcined magnesia 
Essence of peppermint 
Sweet spirits of niter 
Sirup of ipecac 
German mustard (ground) 
Chamomile flowers (Ger- 
man) 
Alcohol 
Witch-hazel 
Glycerin 
Glycerin soap 
Vaselin 
Zinc salve 
Bicarbonate of soda 



Boric acid powder 

Pure talcum powder 

Eyestone or flaxseed 

Absorbent cotton 

Cheese-cloth 

Gauze and muslin band- 
age 

Linseed oil and lime- 
water 

Tincture of iodine 

Thermometer 

Medicine dropper 

Medicine glass 

Ice-bag 

Hot- water bottle 

Fountain syringe 

Small glass syringe 



INDEX 



Abdominal band, 18, 39 
Abscesses. See Boils. 
Abnormal movements, 37 
Accidents, 121 
Adenoids, 54, 115, 117 
Airing the baby, 5, 32; the 

bedclothes, 4 
Albumin water, 82 
Alcohol sponge bath, 104 
Ankle support, 22 
Antidotes for poisons, 128 
Appetite, loss of, 44, 99 
Artificial feeding, 60 

B 

Baby carriage. See Carriage. 

Backward children, 28 

Bad habits, 41, 133 

Baked flour, 85 

Band, flannel, 18; knit, 18 

Barley, gruel, 82; water, 81 

Bath, alcohol sponge, 104; 
bran, 120; cold sponge, 31; 
daily, 15; first, 9; how to 
give, 10; oatmeal, 15, 120; 
oil, 9; requisites for, 9; sea 
salt, 100; sun, 100; temper- 
ature of, 10; thermometer, 
10; when to give, 14 

Bathing, apron, 10; the ears, 
12; the eyes, 14; the fore- 
skin, 12; the mouth, 13; 
the nose, 12; the scalp, 12; 
when to stop, 16 

Bed, 4; clothing, 4; airing, 4 



Bedwetting, 116, 135 

Beef, scraped, 85 

Beef broth, S3; juice, 83 

Bibs, 43 

Bites, cat, 129; dog, 129; mos- 
quito, 123 

Bladder, 36 

Blankets, 22; pinning, 21 

Bleeding, 126, 128; gums, 100; 
nose, 101, 129 

Blindness, 132 

Blisters, 125 

Boils, 123 

Boric acid solution, 13 

Bottle feeding, 62, 64; utensils 
required for, 62 

Bottles, 62; how to clean, 62 

Bowels, 35, 49. See Move- 
ments. 

Bow-legs, 19, 99 

Bran bath, 120 

Breast feeding, 50, 52 

Breast milk, 50; scanty, 55; 
poor, 59 

Broths, 83 

Bruises, 100, 126 

Bumps, 126 

Burns, 125 

Buttermilk, 85 



Carbolic acid poisoning, 128 
Carriage, 33; furnishings, 33; 

sitting up in, 34; feeding in, 

34; sleeping in, 34 
Carrying the baby, 31 
Catarrh, 107, 116, 117 



145 



146 



INDEX 



Cat bite, 129 

Cathartics, 96 

Cereals, steamed, 86 

Chafing, 121 

Chair, toilet. See Commode. 

Chamomile injections, 143 

Chapped hands and face, 122 

Chicken broth, 83 

Chicken-pox, 109 

Circumcision, 137 

Clothing, 18; at night, 24; how 
to put on, 2s; not enough, 
24; street, 24; too much, 24, 
121; when to shorten, 23 

Cold in the head, 6, 16, 107, 114 

Cold spinal douche, 11 

Colic, 38, 69, 90, 97 

Colostrum, 52 

Commode, toilet, 35 

Compresses, cold, 142 

Condensed milk, 99 

Constipation, 51, 64, 76, 93; 
massage for, 94; in rickets, 
100 

Constitutional diseases contra- 
indicating nursing, 55, 60 

Contagious diseases and fevers, 

105 

Convulsions, 91, 102, 105 

Cool sponge baths, 31 

Cough, whooping-, 113; croup, 
in 

Cows' milk for infant feeding, 
60; to preserve, 61 

Creeping, 31 

Crib. See Bed. 

Croup, false, in; true, 112 

Croup kettle, in 

Crusted eyelids, 131 

Crying, 38; causes of, 38, 130 

Cry, normal, 38 

Custard, 84 

Cuts, 126, 128 

Cutting of teeth. See Denti- 
tion. 



D 

Deafness, 117 

Dentition, 44 

Development, 26 

Diaper, 19, 121; quilted pad, 19 

Diarrhea, 70, 77 

Diet for a child from 1 year to 

18 months, 79 
Diet for a child from 18 months 

to 3 years, 79 
Diet for a child over 3 years 

old, 80 
Diet for a nursing woman, 54 
Digestion, 97; weak, 71 
Diphtheria, no 
Disinfection, 106, 109 
Dog bite, 1 29 
Dress, 21 
Drooling, 27, 44 
Drugs for constipation, 96; for 

the medicine closet, 144 
Dusting, 3 



Earache, 39, 130 

Ears, foreign bodies in, 127; 
projecting, 131; running, 
131; to clean, 12 

Eczema, 120 

Egg, soft-boiled, 84; water. 
See Albumin water. 

Emergencies, 125; drugs for, 
144 

Enema, 95, 103, 143 

Eruption, 16, 104; in chicken- 
pox, no; eczema, 120; hives, 
122 

Erysipelas, 42 

Eskay's food, 76, 94 

Exercise, 31 

Experimental feeding, 7 

External applications, 140 

Eyelids, crusted, 131 

Eyes, sore, 131; to clean, 14 



INDEX 



147 



Face, cnapped, 122 

False croup, in 

Feeding a baby with weak 
digestion, 69, 71; a normal 
baby, 64; artificial, 60; 
breast, 50; bottle, 62; during 
constipation, 93; during diar- 
rheal period, 70, 77; during 
fever, 104; during the day, 
52; during the night, 52; ex- 
perimental, 7; general, 49; 
out of doors, 34; top milk, 66 

Fever, 16, 44, 102, 105; scarlet, 
109 

Fingernail biting, 131 

Fingernails, 14 

First outings, 32 

Flaxseed poultice, 140 

Fontanel, 12, 28, 99 

Food formulas, from birth to 
6 months, 65 ; from 6 months 
to 1 year, 66 

Food recipes, 81 

Food, home preparation of , 64; 
Horlick's, 76; Malted Milk, 
77, 94; Mellin's, 76, 94; 
Nestle's, 76, 77; patent, 74 

Foot-bath, mustard, 141 

Foreign bodies in the ear, eye, 
nose, throat and stomach, 
126 

Foreskin, tight, 133, 136; to 
clean, 12 

Foul breath, 13, 116 

Fresh air, by day, 5 ; at night, 6 

Fright, 39 

Fruits and fruit juices for con- 
stipation, 94 



German measles, 108 
Glands, swollen, no, 116, 117 
Goat's milk, 98 
Go-cart. See Carriage. 
Growing pain, 118 
Growth, 26 
Gruels, 82 

Gums, bleeding, 100; spongy, 
100 

H 

Hair, 14, 26 
Hands, chapped, 122 
Hardening, 12; by cold sponge 

baths, 31 
Headache, 101, 109, 135 
Heating the nursery, 6 
Height, 26 
Hiccup, 91 
Hives, 122 

Home preparation of food, 64 
Horlick's food, 76 
Hot- water bottle, 142 
How to hold the baby while 

nursing, 53 



Ice-bag, 142 

Indigestion, 72 

Infant food, home preparation 

of, 64 
Injections into the bowels. See 

Enema. 
Irrigation of the bowel. See 

Enema. 
Isolation, 106 



Gelatin pudding, 84 
General rules for contagious 
diseases and fevers, 105 



Jacket, pneumonia, 141 
Jaundice, 101 
Joints, swollen, 100, 118 
Junket, 83 



148 



INDEX 



K 



Kicking, 31 



Lactic acid milk, 8$ 
Laxative. See Cathartic. 
Legs, bow, 19, 99 ^ 
Lemonade, nutritious, 82 
Length. See Growth. 
Light, 3; at night, 3 
Linseed poultice, 140 
Loose bowels, 64, 70, 77 

M 

Malnutrition, 97 

Malted milk food, 94 

Maltose or malt sugar, 65-68 

Malt soup, 86 

Marasmus. See Malnutrition. 

Massage for constipation, 94 

Masturbation, 41, 135 

Mattress, 4 

Meals. See Diet. 

Measles, 107; German, 108 

Medicine closet, 143 

Mellin's food, 76, 78, 94 

Menstruation during nursing 
period, 55 

Mental development, 27 

Milk, breast, 52; condensed, 
97; cows', 59, 60; for a baby, 
with weak digestion, 67; 
goat's, 98; how to heat, 63; 
howtopasteurize,6o; pepton- 
ize, 71; peptonized, 71; poor, 
59; scant} , 55; skimmed, 78; 
steamed, 61, 63 

Milk crust, 12 

Mixed feeding, 59 

Moccasins, 22 

Mosquito bites, 123 

Mouth breather, 116; care of, 
13, 118 



Movements, normal, $6; ab~ 

normal, 37 
Mumps, 116 

Mustard foot-bath, 92, 141 
Mustard poultice, 140 
Mutton broth, 8^ 

N 

Nail biting, 134 

Nails, to clean, 14; to shorten, 

14 

Napkins. See Diaper. 

Naps, 40 

Navel cord, 9; rupture of, 17; 
sore, 17 

Nervous system, 37 

Nestle's food, 76, 77 

Night air, 6 

Night clothes, 18, 24 

Night terrors, 139 

Nipples, 62; how to clean, 63 

Normal gain, 29 

Normal movements, $6 y 49 

Nose, bleeding, 101, 129; dis- 
charge from, 115; foreign 
bodies in, 127; to clean, 12; 
plugged, 115 

Nurse-maid, 7 

Nursery, 3; heating, 6; tem- 
perature of, 6 

Nursery seat, 36 

Nursing, 53; contra-indica- 
tions, 55 

Nursing woman, diet of, 55; 
foods prohibited, 55; men- 
struation of, 55; pregnancy 

of, 57 
Nutritious lemonade, 82 
Nutritious orangeade, 8^ 

O 

Oatmeal bath, 15, 120; gruel, 

82; water, 82 
Orangeade, nutritious, 83 



INDEX 



149 



Outdoor life, 32, 34 

Overfeeding, 89 

Oxalic acid poisoning, 1 28 



Paregoric poisoning, 128 
Pasteurized milk, 60 
Patent cathartics, 96 
Patent foods. See Proprietary 

foods. 
Peptogenic milk powder, 73 
Peptonized milk feeding, 71 
Peptonizing powders, 71 
Perspiration, 99 
Pillow, 4 

Pinning blanket, 21 
Playthings. See Toys. 
Pneumonia jacket, 141 
Poisoning, 128 
Poor breast milk, 59 
Poultices, 140 
Powder, 10, 11 
Pregnancy while nursing, 57 
Prickly heat, 121 
Proper training, 35; bladder, 

36; bowels, 35; sleep, 40 
Proprietary foods, 74 



Running nose, 115 
Rupture, 17, 40 



S 



Quilted pad, 19 



Rash, 104; German measles, 
108; measles, 107; prickly 
heat, 121; scarlet fever, 109 

Raw scraped steak, 85 

Resting, 35 

Restlessness, 44, 45, 51, 97, 138 

Rheumatism, 118 

Rice, gruel, 82; water, 82 

Rickets, 7, 98 

Ringworm, 124 



Scales, 29 

Scalp, to clean, 12 

Scanty milk, 55 

Scarlet fever, 90, 109 

Scraped beef, 85 

Scurvy, 100 

Shirt, 20 

Shoes, 22 

Sitting up, 27; in carriage, 34 

Skimmed milk, 71, 78 

Skin, diseases of, 120; in jaun- 
dice, 101; sensitive, 15 

Skirt, flannel, 21; white, 21 

Sleep, 40, 52, 139; disturbed, 
40,49 

Sleeping out of doors, 34 

Sleeplessness, 40 

Small-pox, 42 

Snoring, 116 

Soap, 9 

Soapstick, 35, 95 

Socks, 22 

Soft-boiled egg f 84 

Soft spot. See Fontanel. 

Soothing sirups, 41 

Sore eyes, 132 

Sore mouth, 118 

Spasms. See Convulsions. 

Speaking, late, 28 

Speech, sudden loss of, 28 

Splinters, 125 

Sponge bath, alcohol, 104; cold, 
31 

Sprue, 118 

Standing, 27 

Sterilization, evils of, 63 

Stomach, capacity, 64; foreign 
bodies in, 126 

Stools, curded, 69, 72, 97; 
greenish, 72; mucus, 78; 



ISO 



INDEX 



white or clay colored, 101. 

See Movements. 
Street clothing, 24 
Sucking the thumb, 133 
Suppositories, 35, 95 



Turpentine stupes, 141 
Twitching, 105 



Urine, $6, 101 



U 



Talking, 28 

Tea, weak, 84 

Tears, 27 

Teeth, 44; care of, 13; milk, 
45 ; permanent, 45 

Teething. See Dentition. 

Temper, 39 

Temperature, 102; of bath, 10; 
of nursery, 6 

Throat, foreign bodies in, 126; 
sore. See Tonsillitis. 

Thumb-sucking, 133 

Tight foreskin, 131, 136 

Toast, 85 

Toilet chair. See Commode. 

Tonsillitis, 115. 

Top-milk feeding, 66 

Toys, 8, 27 

Training. See Proper train- 
ing. 

True croup, 112 

Tuberculosis, 112 



Vaccination, 42 
Veal broth, 83 
Veil, 25 

Ventilation, 5, 106 
Vernix caseosa, 9 
Vomiting, 45, 69, 89, 97, 101; 
in whooping-cough, 113 

W 

Walking, 28, 32 

Washing out the bowels, 103 

Water, 44, 45, 50, 94 

Weaning, 56 

Weight, 29; gain in, 49; loss 

of, 97 
Weight scales, 30 
Wet-nurse, 60, 98 
Wetting the bed, 135 
Whey, 83 

Whooping-cough, 113 
Window-board, 5 
Worms, 139 
Wrapper, 22 



THE HEALTH CARE 

of the 

GROWING CHILD 

By LOUIS FI5CHER, M.D. 

Author of "The Health-Care of the Baby", "Infant Feeding in 
Health and Disease" y "A Textbook on Diseases of Infancy 
and Childhood"; Attending Physician to the Willard 
Parker and Riverside Hosvitals; former Instruc- 
tor in Diseases of Children at the New York 
Post-Graduate Medical School 
and Hospital; etc. 




12 mo, Cloth , Illustrated, $1.25; by mail, $1.37 



FUNK fcf WAGNALLS COMPANY 

354-360 Fourth Avenue t: :: NEW YORK 



CONTENTS 

PART L — General Hygiene and Development 

I— Channels of Elimination. II— Bathing. Ill— Venti- 
lation. IV— Sleep. V — Amusements. VI— Clothes ; How 
to Harden a Child. VII — School Hygiene; Summer Vaca- 
tions. VIII— Characteristics and Peculiarities of Children. 
IX — Nervous Children; Suggestions for Their Development 
and Training. X — Precocious Children. XI — The Breath. 
XII— The Teeth. XIII— Hygiene of the Hair and Scalp. 
XIV— Growth in Height and Weight. XV — Puberty. 
XVI — Vaccination. XVII— Temperature ; Fever. 

PART IL— Nutrition 

I— The Diet. II — Disorders Arising from Improper 
Nutrition; The Bowels; Constipation; Diarrhea; Colic or 
Cramps ; Intestinal Indigestion ; Rickets ; Weak Ankles ; 
Scurvy. 

PART III, — Catarrhal, Communicable, and 

Systemic Diseases 

I — Catarrhal Diseases; The Throat; Adenoids; 
Tonsilitis; Rhinitis or Cold in the Head ; Coughs. II— 
Communicable Diseases ; Influenza ; Bronchitis ; Bronchial 
Asthma ; Pneumonia; Tuberculosis ; Whooping Cough ; 
Mumps ; Croup ; Diphtheria ; Chicken-Pox ; Measles ; 
German Measles; Scarlet Fever; Typhoid Fever. Ill — 
Systemic Diseases ; Appendicitis ; Malaria ; Growing- 
pains ; Rheumatism. 

PART IV' — Diseases of the Skin and Nervous 

System 

I — Rashes; ^ Insect-bites; Eczema; Erysipelas; Ring- 
worm; Ivy-poison; Sunburn; Frost-bite; Hives; Itch; 
Warts ; Head-lice ; Dandruff". II — Diseases of the Nervous 
System ; Defects of Speech ; Chorea ; Convulsions or 
Spasms ; Tuberculous Meningitis ; Night-terrors ; Paralysis ; 
Spinal Curvature ; Headache. 

PART V. — Miscellaneous Diseases and 

Affections 

Operations in Children; Hernia; Glands; Fainting; Cold 
Hands and Feet; Hiccup; Foreign Bodies in the Ear; Ear- 
ache; Pinkeye; Sties; Trachoma; Fever-sores; Injuries; 
Nose-bleed; Worms; Bed-wetting; Retention of Urine; 
Leucorrhea ; Fissure of the Anus ; Poisons and Antidotes. 

APPENDIX 

Food Recipes ; Local Remedies ; Ointments and 
Solutions. 




HE HEALTH-CARE OF THE GROW- 
ING CHILD is a book written for 
mothers by a physician who is a spe- 
cialist in children's diseases and a well-known 
authority on all that pertains to the care and well- 
being of the little ones. It is designed to inform 
and advise the mother concerning the thousand 
and one details of ventilation, bathing, clothing, 
and personal hygiene that mean so much to the 
welfare of her child and which she can not afford 
not to know. It provides a practical answer for 
the many questions that arise when the doctor is 
not at hand and gives explicit instructions as to 
the treatment to be followed in the more serious 
cases pending his arrival. It will be found an 
invaluable aid when traveling or away from home. 
Every phase of the proper physical care of 
the child, from infancy to puberty, is care- 
fully considered, common ailments are described, 
and treatment indicated. Special chapters are 
devoted to nutrition, diet, the care of the 
teeth, hair, etc., amusements and exercises are 
discust, and poison3 and their antidotes enumer- 
ated. Child psychology, particularly in relation 
to backward and precocious children, is inform - 
ingly and sympathetically treated. The book 
closes with a number of recipes for ointments 
and lotions for sunburn, freckles, eruptions, 
dandruff, etc. 



"A Boon to Parents" 

" This book will be a boon to many a puzzled parent, 
and may assist in saving the lives of thousands of little ones. 
It should find a place in many a library not on the top shelf, 
but within handy reach where the mother or father, worried 
by the first symptoms of approaching disease in the child, 
can lay hands upon it without delay." — The Brooklyn Citizen. 

"A Trustworthy Guide" 

"Because the mother of small children is so often called 
upon to face an emergency when medical help is needed and 
no physician is near, it behooves her to have at hand some 
trustworthy guide for such an occasion and also for the ordi- 
nary care of her children. In this book, Dr. Fischer has 
provided just such a guide."— Burlington Hawk-Eye. 



